HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGRZA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
6
FILLED LAND AFFIDAVIT Stt � ,t4 '0
ty
I, the undersigned, am the owner of the following described property,
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(Parcel Id#/Legal
1591 A �_q l'_A-u&MC�a
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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.
J IU3 EPPE 6eipsjo
Property Owner Name (Please int)
. 1p%�w e�MA�� -
Properly 0wn W Signature Date
STATE OF FLORIDA, COUNTY OF S4 L�_LL�
ACKNOWLEDGED BEFORE ME THIS a5 DAY OF _� p robe ( 20 �C6
BY � �e GC'M-'ai r1 A WHO IS PERSONALLY KNOWN TO ME Q) OR WHO HAS
PRODUCEDAS IDENTIFICATION.
ob " � \-Q I ).l
SIGNAT OF NOTARY UBLIC TiE OR PRINT NOTARY
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
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MCARRIE-ELLEN IWANKONOOVA licState of Florida
Commission # GG 013829
;��� My Comm. Expires Jul 20, 202.0
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