HomeMy WebLinkAboutFILLED LAND AFFIDAVITtKANNED
BY
St I Alcoa Coup v
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 �
(772) 462-1553 �� C ��� fl VE
FILLED LAND AFFIDAVIT OCT . It, 2016
PERMITTIING
St. Lucie GOunty, FL
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Legal description/Address) l & Zb S C7 C`e 4
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)
ropertp(Jwner Sign a Date
STATE OF FLORIDA, COUNTY OF i5*` &C'(' E
ACKNOWLEDGED BEFORE ME THIS/e DAY O 20
BY Z-o ��E �'i-- O [5 PERSONALLY KNOWN E (—_) OR WHO HAS
PRO UC AS IDENTIFICATION.
SIG A OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMB
� a��., CHRISTINE MATIS
ri° e` •s Notary Public -State of R&Ma)
Commission # GG 007074
My Comm. Expires Oct 12, 2020
�''�� BOodad through National Notary Assn.
Revised 04/11/2011
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