HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGIMA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
124-1Ik0o2D _600 /L 5 0 L 0 91-4fPf lylrie
(Parcel Id#/Legal description/Address) I FG - P'CrLt-j F� 3L/ 5— 1
SCANNED
BY
St. Lucie County
i 2L
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.
G qlm 21 k'F l t
Property Own a e- lease Print)
rope j er Signature Datd I4
STATE OF FLORIDA, COUNTY OF S j l..l'C.12
ACKNOWLEDGED BEFORE ME THIS I5� DAYOF HCXI(CM .20�
BY L1 fQyelry Ktgj {Lytrat ✓ WHO IS PERSONALLY KNOWN TOMB (Q) OR WHO HAS
PRODUCED 'r A. LLlCIA.VY:�.0 I I I Y 3 I O I AS IDENTIFICATION.
1 9,,M 3 l—raclfZA
SIGNA IYE OF NOTARY PUBLIC TYPE OR PRINT N ARY
o'tS COMMISSION NUMBER
TIFFANYGAD
MY COMMISSION # FF904585
EXPIRES August 30, 2019
SLCPDSD Revised 04/11/2011 p07l39sa+53 rwuwaa .�