HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE �c
FORT PIERCE, FL 34982-5652 �j9/I i.(�, (A�
(772) 462-1553 vl yU
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FILLED LAND AFFIDAVIT
1, the undersigned,
51lam the owner NrTos 8J.K3eGol75�gasgCKgg escribed tp/2a)(-oje5Rr--R7:'>°/�-9��
—i/ rvonn /J yq—lSrW l$$&:.N
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 , 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.
T 11AN15Z R, jtil�«Y
Property QW>per Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED
1 BEFORE ME THIS DAY OF G 20�
BY 1, )mil vl r/1Cn1`10. � � � _ WHO IS PERSONA.0 xN(1wN �C---) OR WHO HAS
SLCPDSD Revised 04/112011
\TION.
(SEAL)
�dY! °W�. Notary Public State of Florida
'QN Kaylitl J May
7 My ComrttrlIissbn FF 914312
'4"v Expires 10/032019