HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANld.v � airs (DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
SCANNED FILLED LAND AFFIDAVIT
BY
G
St. Lucie County3%� 1� a
A
I, the undersigned, am the owner of the following described property,
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(Parcel IM/Legal description/Address)
for which I have applied to St. Lucie County for a Firial DeveloEmeat Permit. In
accepting this Final Development Permit, BP Number p2 y0 , I acknowledge
that as owner of the above described property; and in acoor ante 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 MILL 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.
6E
Name (Please Print)
Date
STATE OF FLORIDA, COUNTY OF ,�' Lucie_
ACKNOWLEDGED BEFORE ME THIS I / to DAY OF 5 L , 20 / 9 ,
BY 41.5A M iTe I cl WHO IS PERSONALLY KNOWN 70 ME (B;OR WHO HAS
PRODUCED
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SIG14ATIMF OF NOTARY PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 04/112011
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
(SEAL)
RHONDASROWE
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Commission # GG 104656
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BondedPThru Budget Notary Services