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. Lucie County
I, the undersigned, am the owner of the following described property,
1-E �A w 011t 1 3pF t- 1 U)fiy
(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 lq 11 -M il4l , 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 WELL 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.
=�;/l-rz_ . SS5/e0 Zi1—o` e
Property Owner Name e e Print) -
Pr perty Owner Si lure -Date
STATE OF FLORIDA, COUNTY OF
AC OWLEDGED BEFORE ME TIES 1�C� _ DAYOF e.20�
gy �iSi�'p 11 �W WHO IS PERSONALLY KNOWN TO ME La OR WHO HAS
PRODUCED Fly. AS IDENTIFICATION.
i
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
=NIELSENLSENs� ��:Statary Public (SEAL)
��Co 2074814MExpires
2E
SLCPDSD Revised 04/I M011