HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT 'PFc
Building & Code Regulations Division
2300 VIRGINIA AVENUE
��M 01
09
�lOJB
FORT PIERCE, FL 34982-5652
`i..
(772)462-1553
-
40e0epa
041.
I?-c
P'F
FILLED LAND AFFIDAVIT ECE/VFD
Fes 2 6 260
Parrn/h/n
SG t �c!® county
1, t11e unaerslgnea, am me owner of the touowmg aescrtnea property,
L'� 2 6, Fr° -;l-v PLC zor- y ro
(Parcel Id#/Legal description/Address)
SCANNED
BY
St. Lucie County
o -1 k ST • �FL•3-f 1d1
for which I have applied to St. Lucie County for a Fi 1 n---'-^ ent Permit. In
accepting this Final Development Permit, BP Number L� ' -Q!# 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 mainta in form,
adequate drainage off my property which will not adversely a/ the immediate
community.
L 13 frT
Property Owner Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF ST • w G �--
ACKNOWLEDGED BEFORE ME
TIES Qy (D DAY OF (:' .b rV Q 20 1 C'1
BY1A&tf1 l� I Y' 1 � 00.t r'c-- WHO IS PERSONALLY KNOWN TOME OR WHO HAS
PRODUCED
kALko Ck A (1 6
A (% SIGNATUKE OF NOTARY PUBLIC
.1 �^' COMMISSION NUMBER
SLCPDSD Revised 04/I W011
iL7RJfYl,Y(K�4PPA
1<QY4n G Qj —prk--�
TYPE ORTRfNT NOTARY