HomeMy WebLinkAboutFILLED LAND AFFIDAVIT_P_LANNING_&DEVELOPMENT SERVICES -DEPARTMENT___
_ Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT SCANNED
BY
St. Lucie County
I, the undersigned, am the owner of the following described property,
Indian River Estates -Unit 02-BLK 11 LOT 42 and N 14 Ft of Lot 43 (MSP 34/11 S) (OR 682-2808: (973-1409)
(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.
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ProN&I
er Name (Please Printl
\Y
Property Owner Signature
49
Date
'411 1 4,— -r i CU Sw
,A',etr �
STATE OF FLORIDA, COUNTY OF OJT -CIx
ACKNOWLEDGED BEFORE ME THIS ,.f l DAY OF ti�YGC ,UVY ^ . 20
BY W f1ll &q t bl�( �y. n Ni �l H HO IS PERSONALLY KNOWN TONE (El OR WHO HAS
IDENTIFICATION.
TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
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SLCPDSD Revised 04/112011