HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTmr NT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT SCANNED
BY
St. Lucie County
I, the undersigned, am the owner of the following described
f3q-,,i;j) w I �ltWyv
(Parcel Id#H,egal 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 CountyLand 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.
Property Owner Name lease Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF -54- L I -I C :; Q"
ACKNOWLEDGED BEFORE ME THIS , DAY OF [ l C T , 20 0 9
BYGerQld Canc",x)n WHO IS PERSONALLY KNOWN TO ME(1„II OR WHO HAS
PRODUCED
IDENTIFICATION.
SIGNATURE OEYOTARY PUBLIC
TYPE OR PRAM
NOTARY
6& 33bea�OMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/112011
..✓'I
Natary Public State W Flodda t�
aP
Ginger P Hester
.A •apS
�i iP
My Commission GG 330259
Expires 08252023