HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 SCAN Er)
By
FILLED LAND AFFIDAVIT 3)t Lude County
I, the undersigned, am the owner of the following described property,
(Parcel IM/Legal description/Address) 10'761 S OG 106 `N
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.
4 w u /). c4FIXC ./II%I�,'
P perGy Owner Name.(Please Print)
Eoperly Owner Signature
STATE OF FLORIDA, COUNTY OFC • ��Cr
ACKNOWLEDGED }BEFORE ME THIS
BY ,b L Crl eLN%k el
OF NOTARY PUBLIC
COMMISSION NUMBER
Revised 04/11/2011
Date
_DAY OF 20 /S-� �e®
O IS PERSONALLY KNOWN T (_) OR WHO HAS 9
AS IDENTIFICA?
TYPE OR PRINT NOTARY
Gi
ow ak'n Notary Public St�}cg�Fyorida
Christine Matos
`�, c My Commission EE 224190
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