HomeMy WebLinkAboutFILLED LAND AFFIDAVIT 2PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 SCANNW)
BY
St. Lucie Cow*
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
3412-123-0001-000-9
(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 1 9n (0-01.T0, 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.
L Heizler Karen E Heizier
,15-11 q
Date
STATE OF FLORIDA, COUNTY O'Id"
DAY OF 20---I—
WHO IS PERSONALLY KNUN TO ME Zb OR WHO HAS
IDENTIFICATION.
TYPE OR PRINT NOTARY
CONMUSSION NUMBER
(SEAL)
�.yTP4,. Notzry Public St ate of Floritla
Y• Kimberly An Slaughter
SLCPDSD Revised 04/1I2011 y. My Commission GG 123750
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