HomeMy WebLinkAboutFILLED LAND AFFIDAVITl
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
SCANNED
BY
St Lucie Count,
I, the undersigned, am the owner of the following described property,
3y09- /I(-r-0003 -ODU=S 5705 Ave- E-4. ?,'cite. EL 30f-P
(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.
-e�'11\ax\ C-C
Prope er Name (Please Print) d
D
Prope wner Sign Dat
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME (THIS �� DAY OF �� I t'` �`l �'i 20A—
BY E v, JV`^ t �V \ WHO IS PERSONALLY KNOWN TO ME Q OR WHO HAS
PRODUCED ` AS IDENTIFICATION.
Ux--!$ Col [4e_y _e_ S
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
(f'�')-0'1i)-ggCOMMISSION NUMBER
EEN SUE HAYES
onuPss,o,t N FF 2097213
l` •_
MY Commission Expues
March I5, aoiv
SLCPDSD Revised 04/1 I/2011