HomeMy WebLinkAboutFILLED LAND AFFIDAVITi
B•
� -
SK"MA N91"t,
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
12300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
MILLED LANDS AFFIDAVIT
I, the undersigned, am the owner
(Parcel Id#/Legal description/Address)
following described property,
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
7.04.0I(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.
0-(6n4h -I- �cin
Owner Name (Please Print)
�Ow n
Owner Signature
STATE OF FLORIDA, COUNTY OF St LV1G e
D
ACKNOWLEDGED BEFORE
ME THIS CR C) DAY OF _ O 20---t
BY �eC\ 1- �l Cl� \ M\4 \ �J . TOME OR WHO HAS
OF NOT
COMMISSION NUMBER
TYPE OR. PRINT NOTARY
DAVIb N. KNEPPER
:= Commission #,DD M%)
Expires September 25120? 4
./' o.• Bonded ThmTmyFain Insurarke800385•
'I "'�i°�ie`••
AS IDENTIFICATION.
SLCPDSD Revised 08/24/2010