HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, Fl, 34982-5652
(772) 462-1553 j ' SPA
NIV,
FILLED LAND AFFIDAVIT at 4 P)' '�o
00/6 00,
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I, the undersigned, am the owner of the following described property,
1,- 33-3 Ooo 1 -C)0014
(Parcel Id#/Lcgal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number 1;ro2—a'5 %4cknowledge
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 fin-ther 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.
/J� �64 /A) r6)J SA OW 9"SZ2-c-
Property Owner Name (Please Print)
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operty Owner Signature Nine
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE NE THIS q fk DAY OF Qj!jR4ZL 20_L6�
I
'F-NO-F C Tel
BY OR WHO HAS
P RODUCE
AS IDENTIFICATION.
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SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
(SEAL)
CA1111 S. CHAU.S8
;,-Z,ArS Nolary"Publi
- 1c - State -of Florida
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SLCPDSD R"ised 04/11/2011 # EE 2235i16
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