HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA. AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553 RECEIVED
SCANNED I WR 1,0 1021
BY FILLED LAND AFFIDAVIT Parmitting Department
St LUde Counbi I Et, Lucle County
I
i
I, the undersigned, am the owner of the following described property,
(Parcel ld#a;egaf description/Ad
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.
I
Property Owner Name (P1easG rrint)
3 I
Pr erty wn lgnatju Dat
STATE OF FLORIDA, COUNTY OF SST- A 1 e
ACKNOWLEDGED BEFORE ME THIS / O T� DAY OF
BY & 1 1 13-0h vi bt9 in WHO IS PERSONALLY KNOWN TO ME LED) OR WHO HAS
PRODUCED D r A it L Lr{aS oie-8 - 8-7 ' 3y of- O AS IDENTIFICATION.
�jUt�-�, ��b� Yl �--- , i3dlu � ►'1
SIG
ATURE OF NOTARY PUBLIC TYPA OR PRINT NOTARY
�j a �b2 I%` COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
R
Pr ubt'(: State of Florida
in L Bowenommission GG 296212
res 02/0q/2023