HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT SCANNED
Building & Code Regulations Division
2300 VIRGINIA AVENUE BY
FORT PIERCE, FL 34982-5652 St. Lucie County
(772)462-1553
FILLED LAND AFFIDAVIT
RECEIVED
NOV 1 g 'yq
ST. Lucie County, FSrmlttinq I
I, the undersigned, am the owner of the following described property,
IS3113 G-,,Po LO D Ad-pem Di iv£'
(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 , 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.
,X d Q rs MOAPIlt
Property Owner Name (PleasePrint)
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Propefty Owner S1g11tit1B Date
STATE OF FLORIDA, COUNTY OF • x uLC k P_
ACKNOWLEDGED BEFORE ME THIS W+h DAY OF QC l o be r 120 I 1
BY
NUMBER
SLCPDSD Revised 04/11/2011
IS PERSONALLY KNOWN TO ME U.OR WHO HAS
AS IDENTIFICATION.
Tina �II(ra1lrLim
TYPE OR R� NOTARY (�1
SEAL)
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ANGELA BORSODI-BIRMINGHAM
NotaryPuhllc-State of Florida
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Commission # GG 249625
16, 2022
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MY Comm. Expires Aug
Bonded through National Notary Aszn.