HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
�r FORT PIERCE, FL 34982-5652
(772)462-1553LRECEIVEDSCANNED FILLED LAND AFFIDA ?L'•.3BYSt. LuCle County W. FWMI IrI9
I, the undersigned, am the owner of the following described property,
(Parcelld#/Legal
for which I have applied to St. Lucie County fora 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.
UJi 11'/ 7 Im &12v'
Property Owner Name Please Print)
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Prop�erty eI'Signature Dat
STATE OF FLORIDA, COUNTY OF SOM � IUCt d
ACKNOWLEDGED B 'ORE ME THIISS
ma DAY OF 0Ck IOQi .20/2
BY 1 , i/(
WHO IS PERSONALLY KNOWN TO ME ("� 1 OR WHO HAS
PRODUCED
AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC
TYPE OR PRINT NDTARv
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
(SEAL)
,3+'^✓gF: PATRICIA ANN GRIFFIN
MY COMMISSION # GG137624
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