HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL34932-5652
(M) 4622-1553
FILLED LAND AFFIDAVIT
SCANNED
I, the undersigned, am the owner of the following described property, St LUCB r`nl I.,
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number�� ' I acknowledge
tbat as owner of the above described property, an ind 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.
,i /-roorl F/R r5 iGt C
Properly Owner Name (Plena Print)
PropSi&atBre Date
STATE OF FLORIDA, COUNPYOF QA1rl1 dtach
ACKNOWLEDGED BEFORE b01THIS q DAYOF ;rOr1uPrJ 2() 'S
13Y "C tkl4tf'Or% WHO IS PERSONALLY KNOWN TOME L%eORWHO HAS
PRODUCED AS. IDENTIFICATION.
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SIGNATUREOFNOTARY PUBLIC
COMMISSIONNUMBER
SLCPDSD Revised0411 Ik011
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TYPEORPRNfNOTARY
RMARSHALL
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