HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
ffi Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
SCANVEI)
squc1e COnnty
I, the undersigned, am the owner of the following described property,
4426-803-0062-000-7 1651 NW Sweet Bay Cir
(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)
Proper Owner Signature Date
STATE OF FLORIDA, COUNTY OF !Z:5T,
ACKNOWLEDGED BEFORE ME THIS
BYd�1�lLl—
SIGiIATURE OF \i Y PUBLIC
(tom C(Q COMMISSION NUMBER
_ DAY OF 20 ,
WHO IS PERSONALLY KNOWN TO ME LU)OR WHO HAS
AS IDENTIFICATION.
�c�i(� �Pa3oJ c
TYPE OR PRINT NOTARY
(SEAL)
SLCPDSD Revised 04/11/2011 - SAUNTER
SHIRLEY A.
=owaYPUB<:o-s Notary Public - State 01 Florida
. '* . Commission # GG 061648
My Comm• Explres an 31, 2021
Bonded through National Notary Assn.
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