HomeMy WebLinkAboutFILLED LAND AFFIDAVITIMI_010
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 SCANNED
BY
FILLED LAND AFFIDAVIT St. Lucie County
I, the undersigned, am the owner of the following described property,
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(Parcel Id#/Legaldescription/Address) , t/ j//, '? aq_QOQL��OOC
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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P Operty Ow er Nan Please Print)
rope7"Iiniture Date l /
STATE OF FLOP IDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS ll DAY OF �t�wM .20 I —,
BY WHO IS PERSONALLY KNOWN TO ME (E:1) OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE PUBLIC TYPEORP NOTAR�Y
r. ra 095-0 L-AOMMIS ON NUMBER
(SEAL)
MARIA DIAZ
Notary Public • State of Florida
SLCPDSD Revised 04/11/2011
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Commission •'011055017
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