HomeMy WebLinkAboutFILLED LAND AFFIDAVIT (2)PLANNING & DEVELOPMENT SERVICES DEPARTMENT
0 Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 ,c .<`F �Fr�
(772)462-1553 P
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FILLED LAND AFFIDAVIT CIO,
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I, the undersigned, am the owner of the following described property,
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number I , I acknowledge
that as owner of the above described property, and m 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.
Property Owner Name (Please Print)
21611-
Props 01 Signature Date
STATE OF FLORIDA, COUNTY OF �S �C Z% C f f-Z
ACKNOWLEDGED BEFORE At�,T/HI/Sy/ DAY OF t �b ^ 20
BY :Y( 1 I I ZUU/r/I.VII- WHO IS PERSONALLY KNOWN TO ME (El OR WHO HAS
PRODUCED PI i) l_ AS IDENTIFICATION.
t1(t� (lceeQn1,�,
TYPE OR P Al NOTARY �r
SIGNATURE 0 • NOTARY PUBLI
G G �?�. COMMISSION NUMBER
(
l,, ELLEN VAUGHN
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1Stste of Floritla-Notary Public
Commission M GG 270079My CommlBelon
Expirss
Octabor 22, 2022
SLCPDSD Revised 04/112011