HomeMy WebLinkAboutFILLED LAND AFFIDAVITr:rn, k i V o 13a.
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
SCANNED
FILLED LAND AFFIDAVIT BY
St. Lucie County
I, the undersigned, am the owner of the following described property,
3 jo3-: 10
(Parcel Id#/Legal
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 6mur Name (Please Print) LeJfS
Propmly-9wner-Signature &)KeSr
STATE OF FLORIDA, COUNTY OF '4A C:',
19hvte-cWS 2o15
Date
ACKNOWLEDGED BEFORE � ME THIS
- __ i4+k DAY OF 20 15 .
BY M a,, SGt'1'rXn xe� WHO IS PERSONALLY KNOWN TO ME ( ✓1.0R WHO HAS
PRODUCED IDENTIFICATION.
���CvV-e- )oArir3 IYlarie �� (eV
SI NATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
k 3.,,, JOAa' , ' PIE RILEY
Commission # EE 848774
ExpiresDscember4,2016
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SLCPDSD Revised 04/11/2011