HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE W FORT PIERCE, FL 34982-5652(772)462-1553
OCSCANNED FILLED LAND AFFIDAVIT [L—RE7CEIVED
ucie
BY
St. Lucie County
I, the undersigned, am the owner of the following described property,
2325-144-0020-000-3 3401 // S Jenkins Rd Fort Pierce, FL 34981
(Parcel Id#/Legaldescription/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.
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operty Owner Name (Please Print)
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STATE OF FLORIDA, COUNTY OF1
ACKNOWLEDGED BEFORE ME THIS — _DAYOF V iC ,201 I ,
BY 7H r7(l '?/-� KerZCS l/ AJ WHO IS PERSONALLY KNOWN TOME (EI OR WHO HAS
K7 Clv COMMISSION NUMBER
SLCPDSD Revised 04/112011
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TYPE OR PRINT NOTARY
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