HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE SCANNE:G
FORT PIERCE, FL 34982-5652
(772) 462-1553 By
Sty Lucie comy
FILLED LAND AFFIDA I , �,
S E P ? 1 �J,a
I, the undersigned, am the owner of the following describj(i_prQpn unty, Permittingj
(Parcel IftLegal 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.
ff �i9►/1J ��wcS
'Property Owner Name (PI ase Print)
Property Owner gnature
STATE OF FLORIDA, COUNTY OF 5BV k' C.A" F
Date
ACKNOWLEDGED BEFORE ME THIS i�b DAY OF .se+i .e rJ4'- , 2p 4 %
BY LIw i ck 1..Q.4W t!E� WHO IS PERSONALLY KNOWN TO ME ( K) OR WHO HAS
PRODUCED �C�Ga�•"I T -�f�� AS IDENTIFICATION.
Uc
SIGMA O TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
,,,� JUSTIN LEE f-IARDISON
SLCPDSD Revised04/11/2011 ;a° State of Florida -Notary Public
Commission 9 GG 251885
R ir My Commission Expires
August 23, 2022