HomeMy WebLinkAboutfiilled landsPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division--
2300 VIRGINIA AVENUE r_ C C �. V
FORT PIERCE, FL 34982-5652
(772) 462-1553 0 1 20i9
FILLED LAND AFFIDAVIT [AUG
cie county, Permitting
I, the undersigned, am the owner of the following described property,
\11 ^O6a1-G1-Jj-000-
(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.
42jMOA C l6 Ftov-pe-5
P operty Owner Name (Please Print)
Property Owner Signature
STATE OF FLORIDA, COUNTY OF �� ` - JG ,\ `�
Date
ACKNOWLEDGED BEFORE ME THIS a' ` DAY OF
WHO IS PERSONALLY KNOWN TO ME L_) OR WHO HAS
vunnrrr Fn l L AS IDENTIFICATION.
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SIGNATURE OF 9MARY PUBLIC
<,Cri7 �3 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
TYPEO1Zl!— I A
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MY COMP 4ISSION #k GG 022023
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E}CPIRES. Decemter 16, 20 0
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)j Public Underwriters