HomeMy WebLinkAboutFILLEDLAND AFFIDAVITSt. Lucie coant 1
I e
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PLANNING & DEVELOPMFNT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
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FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,/,�,�-5'da-de�3�`vOD -�
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
adeg4te 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.
i
operty Owner Na ase n
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OFF'
ACKI N L "DGED BEFORE ME'THIS DAY OF _ ' 20 ,
�l9 ItIli ./3 lWa-wtIO IS PERSONALLY KNOW TO ME OR WHO HAS
OF
SLCPDSDIRevised 08/24/2010
s AS IDENTIFICATION.
C
TYPE OR PRINT N ARY
COMMISSION NUMBER
04 St
SHERRI FEHtMAf•►
(SEAL)
Comm1010 # GG 187160
ERplras March 14, 2022
®®ndod Thru aodget Notarys