HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE SCANNED
FORT PIERCE, FL 34982-5652 AN
(772) 462-1553 BY
St. Lucie COON
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
3210-111-0020-000-1
(Parcel I01Legal 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.
Evan Miller
Property Owner Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF S-4- I i . P 1 e -
ACKNOWLEDGED BEFORE METHIS aq+6 DAY OF IV IQ r 2 19
L�f BY n n i ll; Ile C WHO IS PERSONALLY KNOWN TOME OR WHO HAS
PRODUCED
SIGNAT • N TARY PUBL C
(; 3 COMMISSION NUMBER
SLCPDSD Revised 04/112011
IDENTIFICATION.
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TYPE OR P TNOTARY
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