HomeMy WebLinkAboutFILLED LAND AFFIDAVIT (2)r
PLANNING & DEVELOPMENT SERVICES'DEPARTMENT
Building & Code Regulations Division SCANNED
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 BY
(772) 462-1553
St. Lucie County
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
03s- 1-t
(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 t� 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.
C3�.iG.y1 I 05 fe 'f y�
P.r-oQpe DD erg� Name (Please Print)
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Properly Ofter Signature Date
STATE OF FLORIDA, COUNTY
ACKNOWLEDGED BEFORE METHIS DAY OF
BY
PRODUCED
SIGNATURE OF NOTARY PUBLIC
COMMISSION NUMBER
'SLCPDSD Revised 04/112011
20
WHO IS PERSONALLY KNOWN TO ME Il OR WHO HAS
W0 1111114(dni fti)`.A
TYPE OR PRINT NOTARY
(SEAL)
State
ELLEN VAUGHN
of Florida -Notary Public
y®P Commisalon # GG 270079
My Commisslon Expires
90t0b8r 22 2022..