HomeMy WebLinkAboutFILLED LAND AFFIDAVITr
CANNA
PLANNING & DE 006
�_l,D�f,,� "- '$9ANVICES 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,
33ZZ-5(70-c02�'-01
(Parcel Id#/Legal description/Address)
�1o211 Drr4GS I d-,, e- r PS (�
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.
�,�rvl�S I Lem t S
Propert Owner Name (Please Print)
z 2��
P rty Owner Sign Lure Date
i
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF 20
_/ 0 ,
WHO IS P 1SE71VALLY KNOWN ME (_) OR WHO HAS
AS IDENT ICATION.
IGNATURE OF NOTARY PUBLIC E OR PRINT NOTARY
D
"COMMISSION NUMBER
(SEAL)
otARY Paula E. O'Brien
Q NOTARY PUBLIC
W s STATE OF FLORIDA
SLCPDSD Revised 04/11/2011 �10E 19t�'� Comm# FF970337
Expires 3/14/2020