HomeMy WebLinkAboutFILLED LAND AFFIDAVITSCANNED
jrle County
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
1 (772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
3y 9 P
(Parcel
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.
11f .j e .V, ri„ 44 f& S _'-3— ICJ al Z
Prope Owner Name (PI Se Print)
Prop4ty Owner Signature Date
STATE OF FLORIDA, COUNTY OIA
D ?
ACKNOWLEDGED BEFORE ME THI'S� �+D,g O� " vL � � 20�
BY J C%% YJ 1 '1'/—t r O WHO Is PERSONALLY KNOWN TO ME (a OR WI40 HAS
TURE OF NOTARY PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 04/11/2611
AS IDENTIFICATION.
— 44"O ,
OR PRINT NOTARY
(SEAL)
AUDREYB. HUMPHREY
=* .: W COMMISSION # FF 174772
g EXPIRES: March 6, 2019
Bonded Thru Notary Pubs Undeaw ters