HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
CIO(/,
FILLED LANDS AFFIDAVIT
1, the undersigned, am the owner of the following described property,
�?-7'-+ S-01 Do&(& 0008T-cr� 6L —rrvcrscfre0-aefkr Rad./L
(Parcel ld#/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.
-Pjle�- 4all
Prope 0 r Name (Please Print)
r'z1,
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS I
DAYOF 1114�711,C44P,20,0— 20 1.2-
BY WHO
IS OR WHO HAS
!En2!j��E
PRODUCED
AS IDENTIFICATION.
4—
fURE OF N6TARY PUBLIC
057
TYPE OR PRINT NOTARY
is
OMMISSION NUMBER
. ..... ROGER A. PRTE
Notary Pdft. Side of Florida
My Cerem. Expires Nov 7,2016
comission ar EE 217257
As
SLCPI)SDRevi�d08/24/2010