HomeMy WebLinkAboutFILLED LAND AFFIDAVITM
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
SCANNED
FILLED LAND AFFIDAVIT BY
St. Lucie County
I, the undersigned, am the owner of the following described property,
HWV 7f- 14 51* ,41 or I Nl vl- Za
(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.
operty er Na a (Please Print) /
t r Signature Dal
STATE OF FLORIDA, COUNTY OF Pr ' Of
ACKNOWLEDGED BEFORE ME THIS \ DAY OF1
BY WHO IS PERSONALLY KNOWN TO J da OR WHO HAS
PRODUCED AS IDENTIFICATION.
9—
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
G 6 Oy s-otIMSSION NUMBER
(SEAL)
0•pO1°,
MABIA DIAZ
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Notary Public - Stile 01 Florida
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Commission #%G 055017
SLCPDSD Revised 04/112011
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My Comm. Expires Dec 13. 2020
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Bonded Through National Notary Assn.