HomeMy WebLinkAboutFILLED LAND AFFIDAVITSCANNED
BY
St. Lucie County
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
I
(Parcel IM/Legal description/Address) L E:o - c O fti` kn},,,
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 r st of (?p rics
Property Owner Name (Please Print)
Property. -Owner Siji a- a Date
STATE OF FLORIDA, COUNTY OF 'St, (—V C 1 C
ACKNOWLEDGED BEFORE ME THIS DAY OF 3V VN-e- . 20 Ll_,
BY !Ae S+C),( Y- n WHO IS PERSONALLY KNOWN TO ME ([:b OR WHO HAS
PRODUCED
�-� zi
SIGNATURE OF NOTARY PUBLIC
SLCPDSD Revised 04/11/2011
COMMISSION NUMBER
AS IDENTIFICATION.
A. T�\onon SI'r"o. �GuJ 16i
TYPE OR PRINT NOTARY
(SEAL)
[&K,N.Notary
% Public State of FloddeThomasina Bowins Commission GG 201733pires 03/2W022
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