HomeMy WebLinkAboutFILLED LAND AFFIDAVITa
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553 SCANNED
BY
FILLED LAND AFFIDAVIT St. Lucie County
I, the undersigned, am the owner of the following described property,
/ D 9 . S. � ..� 9C *, , De P v 1'PJ'cf_ FL 3 �' M
(Parcel Id#/Legal descriptioa/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.
Property Owner Name (P%ase Print) 1p�
'ICJ/ 0
Property Owner Signature el Date
STATE OF FLORIDA, COUNTY OF
AACKNOWLEDGEDBEFORE ME THISO
BYY6/1SP)—fV� HOVl 20,•
IS PERSONALLY KNOWN TO ME 0 OR WHO HAS
PRODUCED , MA/ • fXY C YA _I _ -- AS IDENTIFICATION.
COMMISSION NUMBER
(SEAL)
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•$;?'c?. AUOREY B. HUMPHREY d
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My COMMISSION # GG 303817
„P= EXPIRES: March6,2023 �s
SLCPDSD Revised 04/1 IP_OII ':F6di�°P' Bonded Thru Notary Public Undervr,'dc,