HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DE )�p7VIN�TI`ERVICES DEPARTMENT
Buildi g & Code Regulations Division
2300 VIRGINIAAVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
LAND AFFIDAVIT
I, the undersigned, am the owner lof the following described property,
Id#/Lega
for which I have applied to
accepting this Final Developrr.
that as owner of the above
7.04.01(D), St. Lucie County L
adequate drainage so that the i
I further acknowledge that in I
St. Lucie County is neither of
adequate drainage off my pr
community.
Property Owner Name (Please Print)
r perty wner Signature
STATE OF FLORIDA, COUNTY OF
Lucie County for a Final Development Permit: In
Permit, BP Number , I acknowledge
scribed property, and in accordance with Section
Development Code, I shall be responsible for assuring
ediate community WILL NOT be adversely affected.
ting this permit for the development of this property,
;d nor liable to provide for, or maintain in any form,
rty which will not adversely affect the immediate
ACKNOWLEDGED BEFORE ME THIS ( ! I
BY 4-Y10i
PRODUCED �L D
V&gm-
SIGNATURE OF NOTARY P IC
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
Date
r ` DAY OFrYb-,I-20_[9
WHO IS PERSONALLY KNO TO ME U OR WHO HAS
AS IDENTIFICATION.
CAP-t 0t4F M • (O lL
TYPE OR PRINT NOTARY
�tARyS�
CAROLINE M. YORK
NOTARY PUBLIC
' "211�1M11,14
TATE OF FLORIDA
�
Comm# FF154480
Expires 9/23/2018
(SEAL)