HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND, AVIT Rr-'.ttVED
�'BYN�® DEL' 0 3 <•D'9
St CuC1e CaUn ST. Lucie County, permitting
I, the undersigned, am the owner of the following described rope ,
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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.
Al D N P✓
Property Own Name (Pleas Print)
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Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF Pao P,V.P.(
ACKNOWLEDGED BEFOREE'METHIS 1 —DAY OF DC�r�PC .20�,
BY, l �1A nQ�1^I- l7O-4nfIr WHO IS. PERSONALLY KNOWN TO NE() OR WHO HAS
SLCPDSD Revised 04/11/2011
IDENTIFICATION.
TYPE OR PRINT NOTARY
(SEAL)
JOHN M. KOPP
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Commission p GG 231360
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Expires June 21, 2022
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