HomeMy WebLinkAboutFILLED LANDS AFFIDAVITIq)a-0S95
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRaMA AVENUE
FORT PIERCE, FL34982-5652
(772)462-1553
SCANNED
BY
FILLED LANDS AFFIDAVIT St. Lucie Countv
I, the undersigned, am the owner of the following described property,
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for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number lgln - 039S , 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.
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Property Owner Name (Please Print)
Property Owner Signature VIP
STATE OF FLORIDA. COUNTY OF , �f / ! Lz �-
ACKNOWLEDGED BEFORE ME THIS DAY OF .20
BY /, & V I ✓1 S'fi/nQ!,,f-I<'—' WHO IS PERSONALLY KNDWNTO DR ORWHOHAS
AS IDENTIFICATION.
TYPE ORPRINTNOTARY
ff V51i 1&5- NO1 JISSIGNNUNIBER
M,EMAIOHEW ON O EES
MYCOMMISSI859165
EXPIRES: January 3,2017
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SLCPDSD Revised 08242010