HomeMy WebLinkAboutFILLED LAND AFFIDAVITr SCANNED
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
1 (772)462-1553
FILLED LAND AFFIDAVIT
I
I, the undersigned, am the owner of the following described property,
131a.-5ol- ao�-c�U0-8' 9�- r-I���oShor�.s Lo+�S _
(Parcel Id#/Legal description/Address) (plyy Son+ -a NI.Qr3an
r Fo-A-�,\erce-.
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.
Pr'brefty weer Name ease Print)
Property Owner Signahire Date
STATE OF FLORIDA, COUNTY OF S� I 1 1" G 4t-
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ACKNNO^W.L,EDGED/BEFOR"E�METHIS 94- DAY OF C(,%I 20 tl O
BY 1�,W S d (�%' /(.C! WHO IS PERSONALLY KNOWN TO ME L—) OR WHO HAS
PRODUCED k.J f i VS( jn S-e AS IDENTIFICATION.
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IGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
66 )5516I f? COMMISSION NUMBER
(SEAL)
KRISTINE MICHELLE TAYLOR
1� V6
State of Florida -Notary Public
_* *= Commission # GG 155618
SLCPDSD Revised 04/11/2011 %�v�ae?,� My Commission Expires
October 29, 2021