HomeMy WebLinkAboutFILLED LAND AFFIDAVITBY
PLANNING & DEVELOPMENT SERVICES DEPARTMENTt Lucie COUffi\
Building & Code Regulations Division
2300 VTRGTNIA AVENUE
FORT PIERCE, FL 34982-5652 RECEIVED
(772)462-1553
MAR 12 2018
FILLED LAND AFFIDAVIT Permitting Department
St. Lucie County
I, the undersigned, am the owner of the following described property,
(01V6 -PUS 6 , ;5 66? —
(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 J q6 d - &, &- 5 , 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.
Property dr
%Name (Please Print)
1 �rL
Property Owner tignature
STATE OF FLORIDA, COUNTY OF 5k LL f Z ``i
,5— t z,. -- 2o) 8
Date
ACKNOWLEDGED BEFORE M/ E THIS 1 Z DAY OF M A r",i, , 20 1 % ,
BY ��1 Qrem r„ t � WHO IS PERSONALLY KNOWN TO ME (� OR WHO HAS
PRODUCED
4/1
SIGNATURE OF NOTARYPbLIC
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTWICATION.
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TYPE OR PRINT NOTARY
HEATHER BURFORDIic
-Notary
State of Florida
*= Commission # GG 163217
=* - Expires
� My Commission 202
February 06,