HomeMy WebLinkAboutFILLED LAND AFFIDAVIT`39
- r PLANNING & DEVELOPMENT SERVICES DEPARTMENT
- Building & Code Regulations Division,
2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652
SCANNED (772) 462-1553 pol- �0
BY sr r�,,9 l7
St. Lucie County ����e�epd
FILLED LAND AFFIDAVIT Cow rk) ear
I, the undersigned, am the owner of the following described property,
(Parcel id#/Legal description/Address)
for which I have applied to St. Lucie County for a FiAl Development Permit. In
accepting this Final Development Permit, BP Number Zgknowledge
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.
Property er Name Plea P int)
roperty Owne i a r Date
STATE OF FLORIDA, COUNTY OFI' Gam,
ACKNOWLEDGED BEFORE ME THIS �Z DAY OF 20)-s,
GCCWHO IS PERSONAL Y KNOWN TO ME�.) OR WHO HAS
J b�� PR UCED AS IDENTIFICATION.
4Y
S NA URE OF NOTARY PUBLIC TYPE OR PRINT NOTARY 1.5
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
(SEAL)
141HAHIVA INGRA M
y Public
+ ; -
N"F c
- State of Florida
MYNotarComm, expires Dec 20,
201a
Commission 1# FF 177249
Bonded through National Not
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