HomeMy WebLinkAboutFILLED LAND AFFIDAVITI
- I
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
n, Building &� Code Regulations Division
2360 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Legal description/
for which I have applied to St.
accepting this Final Development
that as owner of the above de
7.04.01(D), St. Lucie County Land
adequate drainage so that the imm
I further acknowledge that in grar,
St. Lucie County is neither oblige
adequate drainage off my prope
community.
,ucie County for a Final Development Permit. In
?ermit, BP Number , I acknowledge
cribed property, and in accordance with Section
Development Code, I shall be responsible for assuring
diate community WILL NOT be adversely affected.
ing this permit for the development of this property,
l nor liable to provide for, or maintain in any form,
ty which will not adversely affect the immediate
Property Owner Name (Please Print)
Property er Signature �, Date
STATE OF FLORIDA, COUNTY OF,
ACKNOWLEDGED BEFORE ME THIS � DAY. OF I � A PC# • 20I "
v" BY �rn D 0J !� e ', �/ � j WHO IS PERSONALLY KNOWN TO ME(OR WHO HAS
PRODUCED �1 L _ AS IDENTIFICATION.
i
ATURE VOTARY PUBLIC TYPE OR PRINT NOTARY
I vvv
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 I =q�} °Y•, AUDREY B. HUMPHREY
+�= MY COMMISSION # FF 174772
9; EXPIRES: March 6, 2019
` !if S44Bonded Th. Notary Public Underwriters