HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
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I, the undersigned, am the owner of the following described property,
3400-N4-- ooa4- oofl-a 57o3 Pe"cler Ave:
(Parcel Id#/Legal description/Address) R- PIc;eLt tv— 4T—
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.
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Property Owner Name (Please Print)
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operty Owner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME IES-fDAY OF 'l�l- � ,20
BY 1)11eM � /u� / WHO IS PERSONALLY KNOWN TOME Zf�OR WHO HAS
PRODUCED Z--4PITFICATION.
/ NOTM Pli6llC
LGC i 4'2r' SWeO OP fLORIDA
SI TURE OF NOTARY PUAVC TYPE OR GG032559'.
COMMISSION NUMBER Exp m 3/9/2020
(SEAL)
SLCPDSD Revised 04/11/2011