HomeMy WebLinkAboutFILLED LAND AFFIDAVITr�
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 SCANNED
FILLED LAND AFFIDAVIT St. Lucie B COUYtft/
I, the undersigned, am the owner of the following described property,
'i"� I`i - Sol l4 y'2.- \56-%,
(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 %6%01-da05 , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie CountyLand 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 Owner Name (Please Print)
Pro J ty CIwner Signature Date
STATE OF FLORIDA, COUNTY OF M R R71 A)
ACKNOWLEDGED BEFORE ME THIS 010-, DAY OF v \) I � �f .20� ,
� BY o FFAI I W l S wa.I WHO IS PERSONALLY KNOWN TO ME (9 OR WHO HAS
PRODUCED
S
6(g 1334-2:7--COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
IDENTIFICATION.
(DAMP_ L S+�OIN AS -
TYPE OR PRINT NOTARY
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h commission #GG133422
Expires Deoember 10.2021
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