HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 cc�l
{772)462.1553
FILLED LAND AFFIDAVIT °Cl/O74,cd
SCBYJVE®
I, the undersigned, am the owner.af the following described property, St tuCl@ CSJt4q Cobblestone Dr County
(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 Owner Name (Please Print)
Iv Ad? h IV
Property Owner Signature mile
STATE OF FLORIDA, COUNTY OF �7 f
ACKNOWLEDGED BEFORE NIE THIS DAY OF .:%G� 20 le
BY WHO IS PERSONALLY KNOWN TO ME (1:11 OR WHO HAS
PRODUCEO, AS IDENTIFICATION.
SIGNATURE OF NOTARY UBLIC TYPE OR PRINT NOTARY
CONINIISSION NUMBERy�,
e ru Notary p 'bitc Slote o1 Fior�d�
(SEAT.) .Q0 P gandra L"Ono GG 02Q251
t �y Commission
'.� •,'� ExP,sesOSi1u12020
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Revised 04111P2011