HomeMy WebLinkAboutFILLED LAND AFFIDAVITg �s- 0e9-7
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division SCANNED
2300 VIRGINIA AVENUE
FORT PIERCE, Fl, 34952-5652 BY
(772) 462-1553 St. Lucie County
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(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.
Jo G fj 1MLP-R1 `- Sh dTT"
Property Owner Name (Ple se Print)
C/zo 14
r perty Owner Signatur Date
STATE OFCOUNTY OF ay I!/
ACKNOWLEDGED BEFORE ME THIS �X~ DAY OF / 20 I ,
�lil'� BY Z1 r/, I' WHO IS PERSONALLY KNOWN TOMECO) OR WHO HAS
PRODUCED ��G -� d55u/ ''J Z -7 �'L PZ( - b AS IDENTIFICATION.
SIGNATURE O`F WTARY PUBLIC
l ?-'rV 113 29 COMMISSION NUMBER
SLCPDSD R"iscd 04/11/2011
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TYPE OR PJPNT NOTARY
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