HomeMy WebLinkAboutFILLED LAND AFFIDAVITSCANNED
BY
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE FL 34982-5652
(772) 462-1553 RECEIVED
FILLED LAND AFFIDAVIT A U G 2 0 2018
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
I-A.ke vio d 6 WK --y N'T-9 — I I S I67S 1 o J6vb I I
(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.
R e- x E-- TuR,'Tg
PrName (Please Print) op Owner
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS �O DAY OF , 20 1 Q
BY I�� �? I�K1'� WHO IS PERSONALLY KNOWN TO ME (El OR WHO HAS
PRODUCED
SIGNATURE OF
TYPE OR PRINT NOTARY
COMMISSION NUMBER
KAREN S. NIELSEN
State of Florida-Ng9gAoublic
_• *= Commission # GG 207484
b FI My Commission Expires
� .tune 12, 2022
Revised 04/11/2011
IDENTIFICATION.