HomeMy WebLinkAboutFILLED LAND AFFIDAVIT1
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553 MANNED
BY
St Lucie Cnunl1v
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
230 a -to 0I - 60) 6) - plo -z-1 iLA3 -c>usk �Ic
(Parcel Id#/Legal description/Address) `"rr.0o c aA A , -ecs Jf jJ LY— A,
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.
Property Owner Name lease t)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OFFS+ • U kl�
ACKNOWLEDGED BEFORE ME THIS 1-t k- DAY OF 201 —(f
BY hVl 6-'�% IS PERSONALLY KNOWN TOME OR WHO HAS
PRODUCED
SIGNATURE OF NOTARY PUBLIC
6Ytq-� `i3 COMMISSION NUMBER
SLCPDSD Revised 0411 I/2011
AS IDENTIFICATION.
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