HomeMy WebLinkAboutFILLED LAND AFFIDAVITi
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
o Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) dG2-1553
j FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
/2-77Y n/w /ylaz//✓fin CA
(Parcel Id#/Legal description/Address)
for which I have applied to St. Luce 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 f'or 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 1which will not adversely affect the immediate
community.
i
Property Owner Signature
STATE 01: FLORIDA. COUNTY OF
BY YV►LIIl
PRO U ED 1'
GNATURE OF N
SLCPDSD Revised 04/11/2011
.�. j
Date
ME THISI DAY OF 20,
'1r��_/���''1��''��r���✓✓1`/��+��///�}}}{jj===������`--11110IS PERSONALLY KNOWN TO ME (_) OR WI1011AS
r I _. _I_ _ AS IDENTIFICATIC
NUMBER
OR PRINT NOTARY
FARA D HERNANDEZ
MY COMMISSION #FF172419
rp A EXPIRES October 28, 2018
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