HomeMy WebLinkAboutFILLED LAND AFFIDAVITl
._, PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
� (772) 462-1553
FILLED LAND AFFIDAVIT MAR 0 2 2010
PERrg7 rr1NG
St. Lurie CQun y, FL
I, the undersigned, am the owner of the following described property,
1�7\S a'7 ?� ,� 2 '�� i3 �7'� icol 1 Acmes 0?3 I Su 19�� ��r✓�
(Parcel Id#/Legal description/Address) lFbek V14FEW-1 FL -
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. SCANNED
BY
J h t St Luce County
Property Owner Name (Please Print)
P o erty Owner SigAture j Date
STATE OF FLORIDA, COUNTY OF `5 -
ACKNOWLEDGED BEFORE
EMMEjTHIS
� G7 7� DAY OF 172�e P 20
BY �yD/��?7 P1� WHO IS PERSONALLY KNOWN TOME (�)/ OR WHO HAS
71D AS IDENTIFICATION.
SIGNjATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
/ LOY7 COMMISSION NUMBER
REgf
ate of Florida FF185297'Nor 18
SLCPDSD Revised 04/11/2011