HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
2 ,1'L- ecO- 000(p - 000 -
(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 provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
,//,, L.
Property Owner Name Print)
Property Owner Signature
STATE OF FLORIDA, COUNTY OF I AS V--m A nl R W &R
Date
141
ACKNOWLEDGED BEFORE ME THIS DAY OF I - E rn n,F 1� , 20_,
By jE jjRTLF tt> ifoN , l/ WHO IS PERSONALLY KNOWN TO ME ([D) OR WHO HAS
PR DUCED Imo— L - AS IDENTIFICATION.
A <�6Lf S
SIG TUR OF NO Y PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
KARLA BOLES (SEAL)
o P& Notary public, State of Florida
a CoMeI8Slonii FF 149320
My Comm. expires Aug.
SLCPDSD Revised 04/11/2011 .N- -