HomeMy WebLinkAboutFILLED LAND AFFIDAVITSG I CU
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE,YL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel Id#&4al description/Address)
S(,HI1 vLu
BY
St. Lucie Counts.
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.
ProperqOwner Nam (Pleas pint)
ropertyOwner Signature Date
STATE OF FLORIDA, COUNTY OF:f* Lu Cat
ACKNOWLEDGED BEFORE ME THIS C DAY OF. <�)C.'\ .20 S3
BY Aat ",A M\zev,r. WHO IS PERSONALLY KNOWN TOME ✓ OR WHO HAS
—Sta„— A QSN ec'
PRODUCED
W\ tN
.SIGNATURE OF NOTARY PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 08124,2010
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
(SEAL)
umy
e�rw+>aac, STELLA M HUNTER
• �- Notary public - State of Florida
My Comm. Expires Jan 23, 2015
�'•;?o„goer Commission N EE 31278
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Bonded Through National Notary Assn.