HomeMy WebLinkAboutFILLED LAND AFFIDAVITl
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGROA AVENUE
FORT PIERCE, FL 34952-5652
(772)462-1553
FILLED LAND AFFIDAVIT
SCANNED
I, the undersigned, am the owner of the following described property, BY
4224-501-0095-000-0 St. Lucie County
(Parcel Id#/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.
Ajclm z I AAi2d'fWL
Property Owner Name (Please Print)
Property Owner Sign&= Date
STATE OF FLORIDA, COUNTY OF St Lucie
ACKNOWLEDGED
!BEFORE ME THIS 1 � � Jul DAY OF U & .20 I
/i I BY 1 chAe,1 ma m ho r 1 WHO IS PERSONALLY KNOWN TO ME (x) OR WHO HAS
PRODUCED
SIGNATURE O NOTAW PUBLIC
GCOMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
Paula S. Breier
TYPE OR PRINT NOTARY
(SEAL)
:nY/Paulaby%z Ber
Comm s4 GGWW3
Evin September 15,220
Banded in Aaron Notary