HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
FORT PIERCE,FFL349V825652 REC-rz:5vic�:,)
SCANNI=b (772) 462-1553
BY FEB 0 3 2016
St. Lucie Counts FILLED LAND AFFIDAVIT PERMITTING
St. Lucie County, FL
I, the undersigned, am the owner of the following described property,
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(Parcel IM/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 /.TQ 03];, 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"66mmunity 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.
Will tAmn A nip M'9
Property Owner Name (Please Print)
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ProplKy Ownnler'Signature Date
STATE OF FLORIDA, COUNTY OF �i4 % •4d. -ze'oG 4
ACKNOWL GED BEFORE ME THIS .Z DAY 1-� OF P D e u A r Y �. 20 / 6
[,
BY w � A4'^ A Q 1 X' S WHO IS PERSONALLY KNOWN TO ME (_)V oR WHO HAS
PRODUCED
SIGNATURE OF NOTARY PUBLIC
40�I COMMISSION NUMBER
SLCPDSD Revised 04/112011
AS IDENTIFICATION.
ANDRIA M. SCHEELE
Notary Public - State of Florida
. ; ; • My Comm. Exp F7
eh 27, 2016
Bonded Through Na n�al))NotaryAssn.