HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulation's Division
2300 VIRGINIAAVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
SCANNED
FILLED LAND AFFIDAVIT BY
St. Lucie County
I, the undersigned, am the owner of the following described property,
(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 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 for, 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.
I 11inoll Syn, AdUln9
Property Owner Name (P ease Print)
� �o
Property'ignature Da
STATE OF FLORIDA, COUNTY OF.SQIA� �,ue1C
ACKNOWLEDGED BEFORE ME THIS����rr DAY OF I / 20��
BY INL�i�Q�'b��?tfl kd&nSWHOISPERSONALLYKNOWNTOMEI_)ORWHOHAS
AS IDENTIFICATION.
/SIGNATURE OF NOTARY PUBLIC YPE OR PRINT NOTARY
COMMISSIONNUMBER
.% PATRICIA ANN GRIFFIN
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MY COMMISSION # OG137624 EXPIRES September 26, 2021
SLCPDSD Revised 04/11/201 l