HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
SCANNED
Building & Code Regulations Division BY
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 St. Ludo Co080
(772)462-1553
RECEIVED
FILLED LAND AFFIDAVIT A U G 16 2018
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
5a1 t) 1 ''� $�- 1�.
(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.
C'� R2vti
Property r Name se Print)
Propert§Qw
,4& a re Date
STATE OF FLORIDA, COUNTY OF 19 i
ACKNOWLEDGED BEFORt��OISPE
—DAY OF 20
BY C�O.t9 "` R2RSONAL KNOWNTO ME OR WHO HAS
AS IDENTIFICATION.
SIGNATURE OTARY PUBLIC ! YP OR PRINT NOTARY
l COMMISSION NUMBER
(SEAL)
P
t44NCY MIMS AR
'r3 MSTRpNG
M' COMMISSION # FF19.7899
Revised04/11/2011 '"9;, ,
ao EXPIRES February 10, 2019
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