HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIAAVENUE RECEIVED
FORT PIERCE, FL 34982-5652
(772)462-1553 AUG 0 9 2019
FILLED LAND AFFIDAVIT 5T. Lucie County, Permitting
SCANNED
BY
I, the undersigned, am the owner of the following
gddescribed
�property, St. LucieConyt/
- fAA I kM JAi , f7 17 ' Y/,n� iL1 'eQ- �Z7 S
for which which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number 191J� 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.
yes �Cj d yca51 -33
Property Owner Na to (Please Print)
Prope-eUwner Signature Date
STATE OF FLORIDA, COUNTY OF
AC OWLEQ�BB-HEFORE ME S, _DAY OF 20 9—
BY TpC// / WHO IS PERSONALLY KNOWN TO ME(_) OR WHO HAS
PRODUCED /JL /' AS IDENTIFICATION.
TYPE OR PRINT NOTARY
COMMISSION NUMBER
������., KAREN S. NIELSEN (SEAL)
,��`pY eb¢s; State of Florida -Notary Public
- =Commission fi GG 207484
;fie My Commissi 20 Zpires
'��, ,°,;;,`,.� June 12,
SLCPDSD Revised 04/I I201(