HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE _
FORT PIERCE, FL 34982-5652�I�'
(772) 462-1553
SEP 24;Tj
FILLED LAND AFFIDAVIT
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property, Lucie County
2 08-W3-005(0 W5 W 405E Fog, 91,58GE
(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 %JOI.056, 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 Owne ame lease P int)
elty weer Signature Date
STATE OF FLORIDA, COUNTY OF off"
AC WLEDGED BEFORE ME THIS DAY OF 2010
WHO IS PERSONALLY KNOWN TO ME Zb OR WHO HAS
&PD AS IDENTIFICATION.
Is"
E OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
LASHANNA INGRAM J
(SEAL)
s Notary Public - State of Florida
•E My Comm. Expires Dec 20, 2018
Commission # FF 177249
SLCPDSD Revised 04/11/2011 %°......
; .. Bonded through National Notary Assn.