HomeMy WebLinkAboutFILLED LAND AFFIDAVITSCANNED
BY
St. iLUCe(B C(Duflty
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982 5652 RECEIVED
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
JUL 2 7 2018
ST. Lucie County, Permitting
H ar kL.v- Qi d ae Play- (Q Pu.p I remui I In►r ,LU> i - )S
(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.
Property O me (Please Print) j
-Ib-10
Property OwAr Signature Date
STATE OF FLORIDA, COUNTY
ME
---ITT'! DAY OF
COMMISSION NUMBER
SLCPDSD Revised 04/112011
200
.Y KNOWN TO ME O ) OR WHO HAS
AS IDENTIFICATION.
TYPE OR PRIIVT N Y `
r TRACEYW.MCGHF-F.
NOTARYPUB
STATE OF Ft.
Comn* FF20935
e E)pires E11012019