HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE SCANNED
FORT PIERCE, Fl, 34982-5652 BY
(772) 462-1553 St. LUCIP CrI
FILLED LAND AFFIDAVIT
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I, the undersigned, am the owner of the following described property,
339a- dal - 0001 - 000 { g goon Cjvb{teyLe 1i%4C _ naj St• J.,4 e F Fj
(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.
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Property Oyer Name (Please Print)
Property CwFi& Signature Date
STATE OF FLORIDA, COUNTY OF 54- G✓A e
ACKNOWLEDGED BEFORE ME THIS (O -fx DAY OF A-4R I .20 J S
BY I tjr2 N. CA/'I it WHO IS PERSONALLY KNOWN TO ME (X ) OR WHO HAS
PRODUCED
SIGNATURE OF NOTARY PUBLIC
8-11-a019 COMMISSIONNUMBER
SLCPDSD Revised 04/112011
IDENTIFICATION.
TYPE OR PRINT NOTARY
1p every s
GREEN
112 005
empires Aagus111. 2018 �0
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