HomeMy WebLinkAboutFILLED LAND AFFIDAVIT_ v PLANNING & DEVELOPMENT SERVICES DEPARTMENT
e Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 RECEIVED
FILLED LAND AFFIDAVIT I JUN 10 2019
ST. Lucie County, Permitting
SCANNED
I, the undersigned, am the owner of the following described property, BY
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1-31z-Sa3-obio-doo-g St. Lucie Coun�/
descriptiontAddress)
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.
//� Property O�wner�NameO(Please Pr'm[)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAYOF h?,4tl .20�
BY Llcec WHO IS PERSONALLY KNOWN TO ME(11 OR WHO HAS
PRODUCED AS IDENTIFICATION.
�d"o fd'u�.t� LUi l c S
ATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
SLCPDSD Revised 04/112011
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