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 �f, C9ti
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I, the undersigned, am the owner of the following described property,
3211-701-0016-000-4 18102 Bridle Way Ft. Pierce FI.34987
(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 1812-0346 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.
rin' c ri adto
Property Owner Name (Please Print) q
Property'—OwnCrr Signature Date r
STATE OF FLORIDA, COUNTY OFs
ACKNOWLEDGED BEFORE M THIS L..� DAY OF V V'l.� I 20 1
BY _WHO IS PERSONALLY KNOWN TOME OR WHO HAS
oonnrrcn t r o r y- G AS IDENTIFICATION.
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/112011 EM
YNTHIA D. DENNIS Public -State of Floridamission # GG 182845mm. Expires Feb 5.2022ugh National Notary Assn.