HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE AwnOo wnl Is
FORT PIERCE, FL 34982-5652
(772) 462-1553 As
CONNHOS
FILLED LAND AFFIDAVIT RFCF/�
`o'U( 2g10jS
I, the undersigned, am the owner of the following described property,
3a 39 No w 7do TT of E 3/,4 o t W a, o £ N\V 1/N - Less t4 go FT - C ao 73 A4I0 r 3 \ 3o - 4YG i
(Parcel ld#/Legal description/Address) 31015t•,LUaZr-%%ve1, 8't.Qte,ec-ePLI34i'l`-Ico
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 Owner Name (Please Print)
—9 -1S
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE BEFORE ME THIS DAY OF / 20�,
BY ,(f/w�G /✓%� WHO IS PERSONALLY KNOWN TO ME Ct )OR WHO HAS
PRODUCED
/SIG�NAT�7URE OF NOTARY PUBLIC
GG11'000 COMMISSION NUMBER
SLCPDSD Revised 04/1 I2011
TYPE OR PRINT NOTARY
HEIDI A. P17T"
NOTARY PUBLIC
STATE OF FLORIDA
Comm* EE118017
Expires 1004016
AS IDENTIFICATION.