HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652,
(772) 462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
41422 ` 81n - 0010 - Coo/ Fb. 5A _ IJw C-"-A r5 � r.ro_� eA, Palm ci F F(�
(Parcel Id#/Legal description/Address) 3 Ll 4.1 O
for which I have applied to St. Lucie County for a Final Development -Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this :property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not :adversely affect the immediate
community.
c� F �.
Owner N (Please Print)O. 1'(• it
(,_�)rroper
operty Own r Signature Date.
STATE OF FLORIDA, COUNTY.OF�1
ACKNOWLEDGED BEFORE ME THIS I `I L� DAY OF L _ J` io b ,J 20 N ,
BY L .i 5 a A h Sl. nJ . WHO IS PERSONALLY KNOWN TO MEN OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNAAT O NOTARY PUBLIC TYPE OR PRINT NOTARY
bb gbon1 %Ai3 COMMISSION NUMBER
.`�► "' "�d BRANDY WATLEY .
Notary Public - State of Florida
, ;My Comm. Expires May 9, 2014
SLCPDSD Revised 08/24/2010 " •.i� of coo:•` Commission' DD 989743
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