HomeMy WebLinkAboutFILLED LAND AFFIDAVITV
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT SCANNED
BY
St. LUcip (,011nth,
I, the undersigned, am the owner of the following described property,
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.
Pro rt} er Name (Please Print)
is /5
P operty Owner Signatu
Date
STATE OF FLORIDA, COUNTY OF 1l1cl'QVl P—IVe—f
ACKNOWLEDGED BEFORE ME THIS I Z DAY OF J U Vl e . 20 IS
-
BY .
BY FICkIQVA E bffVy WHO IS PERSONALLY KNOWN TO ME()�,jOR WHO HAS
PRODUCED
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
FFIOIZO-I IO COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
M 61:0-11114comiN)zA
�� CHRISTINA A. SOLANO
MY COMMISSION k FF192076
�'e �e� R7(PIRES: January 22, 2019