HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
SCANNED
BY
FILLED LAND AFFIDAVIT St. Lucre County
I, the undersigned, am the owner of the following described property,
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(Parcel ld#/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.
Property er Name (Please Print) J
1
t
Property Owner Si ature STATE OF FLORIDA, C UNTY OF "�I I I• W G/ e.
ULI
4q. J0 I 19
Date
ACKNOWLEDGED BEFORE ME THIS / ZD DAY OF , 20 /
BY F-/SA M �� d WHO IS PERSONALLY KNOWN TO ME (ErOR WHO HAS
PRODUCED
Atrna'3� �— 1\tlu-Li
SIGNATURE OF NOTARY PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 04/11201 I
IDENTIFICATION.
TYPE OR PRINT NOTARY
(SEAL)
,�I,pY PUg�
RHONDASROWE
Commission # GG 104656
N^ AP
Expires May 19.2021
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