HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
. 3 `l0Z - (o/o - 022) - oo/ �Bo9
Id#/Legal description/Address)
TZ-r
SCANNED
BY
St. Lucie County
,f 3yy�2
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.
Drn'tyc 4 H", 1�, -� r .fir tV },rerise s LLG
Pro erty Owner Name (Pleas riot)
a-aT- as/i
Property Owner Si q9ure /' I' • Date
STATE OF FLORIDA, COUNTY OF 9bf WWV
ACKNOWLEDGED BEFORE ME THIS �� DAY OF .20/g%
BY
PRODUCED
CONMUSSION NUMBER
SLCPDSD Revised 08/24/2010
IS PERSONALLY KNOWN TO ME —OR WHO HAS
AS IDENTIFICATION.
r>n` D pal
(SEAL)
'�: qa"••.
AUDREYB.HUMPHRE�EY
s
MY COMMISSION ✓Z FF 174772 11
EXPIRES: March 6, 2019 1
�Q; 4
`.�'%'f„9fh4P•'
9oMed ThnuNofary Publ¢Undzrnriters i.