HomeMy WebLinkAboutFILLED LANDS AFFIDAVITIlo �Do7y s
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 SCANNED
(772)462-1553 By
St. Lucie Cotinty
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
142,5-701-clal,
(Parcel Id#/Legal desc
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number Q� 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 permif 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.
U
Prope weer Name (Please Print)
Property O er ature Date
STATE OF FLORIDA, COUNTY OF ea.S'C B
ACKNOWLEDGED BEFORE ME THIS DAY OF ALkJUS4 ,20 1
BY 1�pl� r, �� C •�.� ?ilyl i O h wH PERSONALLY KNO O ME OR WHO HAS
PRODUCED
;"� -�Ifi , �a -
SIGNATURE OF NOTARY PUBLIC
r6 &3 9 IpCOMMISSION NUMBER
Revised 08/24/2010
AS IDENTIFICATION.
6his h- FiAer
TYPE OR PRINT NOTARY
(SEAL)
DONNA M FISHER
•'"z MY COMMISSION # EE116399
EXPIRES Juiy 27, 2015
407 39"10. Fltlr 1+et111