HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
SCAN N, ED FILLED LAND AFFIDAVIT
BY
I, the undersigned, am the owner of the following described property,
3334-501-0216-000-0 LAKES AT PGA BLOCK D LOT 78 9232 SHORT CHIP CIR
(Parcel Id#/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.
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STATE OF FLORIDA, COUNTY OF.
ACKNOWLEDGED BEFORE
o— 'RE ME THIS I DAY OF `6 . 20
BY & 10 r 1 a i-1(.Lr< V Q.�Z t S WHO IS PERSONALLY KNOWN TO ME L__) OR WHO HAS
AS IDENTIFICATION.
OF NO AR PUBLIC TYPE OR PRINT NOTARY `�
COMMISSION NUMBER
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MY COMMISSION #FF172419
EXPIRES October 28, 2018
SLCPDSD Revised 04/I 112011
(407) 398-0153
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