HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT '
Building & Code Regulations Division _
FORT PIERCE,FFL 3 82- AVE652 t"'P F
(772)462-1553
DEC .15 2017
FILLED LAND AFFIDAVIT P-='RM17TING
-St. Lucie County, FL
I, the undersigned, am the owner of the following described property,
�G3 LAV-t LkJuA 6 CA; i a,P— PH, t:P-(-C- 3`rgVO
(Parcel Id#/Legal description/Address)
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 for
for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
Property Owner Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF A-ij 1 C _e
ACKNOWLEDGED BEFORE METHI= \l" S _ DAY OF , 20�,
BY ^YY11A-� P 1 i) & YAW WHO IS PERSONALLY KNOWN TO ME (Eb OR WHO HAS
PRODUCED
ARY
TYPE OR PRINT NOTARY
COMMISSION NUMBER
KAREN S. NIEL
Commission # FF SEN7
1156�SE
:N '= filly Commission ExPir s
June 12, 2018
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.