HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
. ' Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462.1553 RFC
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.FILLED LAND AFFIDAVIT per OCr 2 Zp�g
S ,4U L, epor dent
I, the undersigned, am the owner of the following described property,
Cobblestone Dr
(Parcel W/Legal description/Address)
sceN�EO .
live o
4hty
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 Owner Name (Please Print) V
0
Property Owner Signature Date
St
STATE OF FLORIDA, COUNTY OF �°�VUY
ACKNOWLEDGED BEFORE NIE THIS. Z4 DAY OF .20 le
BY WHO IS PERSONALLY KNOWN TO NIL (0) OR WHO IIAS
PRODUC AS IDENTIFICATION.
SIGNATURE OF NOTARNPUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER pu54c Stote of Ftoada
gt ry Notary
(SEAL) t�• 5anGO dca t Cope 020251
Commission
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SLCPDSD Reviscd04111)'2011