HomeMy WebLinkAboutFILLED LANDS AFFIDAVITt
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE c' .
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
131250200990002 5431 PLACE LAKE DR
(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.
Property Own me (Please Print)
S z 9
Property O er ignature Date
STATE OF FLORIDA, COUNTY OF ST LU C I E
ACKNOWLEDGED BEFORE ME THIS r� L DAY OFG'�- 20 0
BY IS PERSONALLY KNOWN TOME ❑U OR WHO HAS
AS IDENTIFICATION.
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TYPE Ok PRIN OTARY
NUMBER
(SEAL)
•;�;;_¢;% PAGE L. JARRIEL
SLCPDSD Revised 04/11/2011 Commission # FF 968344
Expires April 14, 2020
;;'••' Bonded TtruTroy Fain lnsurance800.385.701P