HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 SCANNED
(772) 462-1553 BY
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel IM/Legal description/Address)
St. Lucie County
LaT'/S 15(h(17
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.
\\ V A k \e) l
Property Owner Name (Please
Property Owner
STATE OF FLORIDA, COUNTY OFF /,C �,n ,60 CL—�
ACKNOWLEDGED BEFORE ME THIS ck;2f DAY OF ✓/ L .20 g
BY( �4d Y���� i'- -" WHO IS PERSONALLY KNOWN TO ME ([-I)
�OR WHO HAS
PRODUCED /'�L 1) L- AS IDENTIFICATION.
4NATUREOFN LIC
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
CL/.ii/!t ✓ �j7n a1 ��
TYPE OR PRINT NOTARY
'Q `m JESSIDA S. StatSTIe
of 1
(�IPublic, State of Florida
Commission# GG 57813
Idy comm. expires Dec. 26. 2020