HomeMy WebLinkAboutFILLED LAND AFFIDAVITwl ni'� P�. Cra �. 4ovfi� RECE11.":l7 FEB 26 a16
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Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
SCANNED (772) 462-1553
BY
at. jLUdeCoUnty FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
33a,a 1a.a c3o
(Parcel IM/Legal description/Address)
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.
Property Owner Name (Please Print)
Prolleily.Owner Signature Date
STATE OF FLORIDA, COUNTY OF V, L" C e
L --
ACKNOWLEDGED BEFORE ME THIS ' 7 . DAY OF 20 I IC
BY to h er A - �I � � WHO IS PERSONALLY KNOWN TO ME CZ) OR WHO HAS
PRODUCED
SIGNATURE OF NOTARY PUBLIC
f CONIMISSIONNUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
f17'!n.q /°lr/?.i Gv4°✓J
TYPE OR PRINT NOTARY
iv",, R AN IE GREEN
Commission # FF 112005
Expires August 11, 2018
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