HomeMy WebLinkAboutFILLLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGD41A AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT APR 16 ?019
ST. Lucie Count
I, the undersigned, am the owner of the following described property, SCANNED
js1gq Chernj 1�c)IY) G>l� Ii BY
(Parcel Idk/Legaldescriptio Address) St. Lucie our
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
7.04.0l(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.
Proper O a ease Print)
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Prope Owner Signa re D
STATE OF FLORIDA, COUNTY
ACKNOWLEDGED BEFORE METHIS DAY OF n'�Y Cr � .20_ 1
BY Srn 1.ry Lgtas0 WHO IS PERSONALLY KNOWN TO ME(I ^lOR WHO HAS
PRODUCED FO L AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC
COMMISSION NUMBER
A 1 l otngS:M &0W1%o
TYPE OR PRINT NOTARY
(SEAL)
pm°yr Notary Public State of Flaritla
SLCPDSD Revised 04/112011 ;� � A 7homaSina BoWins
`a� p• My Commission GG 201733
tk M1tl" Expires 03/292022
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