HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 kr-CtIVEL)
FILLED LAND AFFIDAVIT JUL 0 2 2018
SCi NNt-W ST. Li+cie County, Permittinn
By B_.
St {L680 f',l11 nt'
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Legal description/.
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.
h I E W; I - C, T\, 4 eL-l"n
Property Owner Name (PYease Print)
r IN
nwn - I co g
Property Owner Signature Date
t
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS Gd 7" DAY OF - / L1,AJ 120 le
BY / / //�G C C C> / j/Sd •V WHO IS PERSONALLY KNOWN TO ME () OR WHO HAS
AS IDENTIFICATION.
CP
SI ATURE OF N ARY PUBLIC TYPE OR PRINT NOTARY
216 //,P / COMMISSION NUMBER
(SEAL)
""pRV P&&g,. ROSE MARIE COOPER
SLCPDSD Revised 04/11/201 ] r� B+= Notary Publle . Stda 01 Fjorlda
;� �r Commbalon 0 FF 900855
to
My Comm. ExplJul 18, 2019
Bonded through N tlo 1al Ndtsy Assn.