HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
NOV 0 5 2018
ST. Lucie County, Permitting
1, the undersigned, am the owner of the following described property,
OUANNED
BY
'-t Lucie County
5'1,7-S01, ool) -o0D-I t 02o S MS&A D&Z-re,
(Parcel IM 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
com
operty owner Name (PI Print)
erty Own gnature Date
STATE OF FLORIDA, COUNTY OF ST LUCI E
ACKNOWLEDGED B F RE ME TH[S DAY OF 20��
BiUCED
- - WHO IS PERSONALLY KNOWN TO ME (a OR WHO HAS
P AS IDENTIFICATION_
SIGNATURE OF NOTARY PUBLI
COMMISSION NUMBER
SLCPDSD Revised 04/11/201 t
TYPE OR PRINT NOTARY
�` Notary Public State off Florida
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�{ Q INy Commission GG 092440
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