HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGI1,114 AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property, SCANNc-LI
/V3/ `70/- 0 /6y--yy0 -6 St. Lij r„ ,
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 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.
Name (Please Print)
11,115119
Date
STATE OF FLORIDA, COUNTY OF & kt,6 , q
ACKNOWLEDGED BEFORE ME THIS DAY OF 416V , 20 / /
BY 1Q/ i� /� ��//,, WHO IS PERSONALLY KNOWN TO ME ❑() OR WHO HAS
..J nnrrn /� PYA' AS IDENTIFICATION.
1 S)ki1�.TURE OF NOTARY(PLIC U TYPE OR PRINT NOTARU
�� COMMISSION NUMBER
(SEAL)
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EXP RM D9cer W 20.2022
SLCPDSD Revised 04/11/2011 BOIM¢d71-RQWYPUMUndembm