HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 SCHNNty
FILLED LAND AFFIDAVIT St. Lucie COUOtV
I, the undersigned, am the owner of the following described property,
(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.
:A..t suIJJlf44
Property OwOwner Name Please Print)
.dk
Property Owner Signature
STATE OF FLORIDA, COUNTY OF Ti4 Iiw 24p a C
Date
ACKNOWLEDGED
� B�EFO�'RAiv
M
E ME THIS DAYOF /�nT` �.20,��,
BY ' Rr � -% M'LC— WHO IS PERSONALLY KNOWN TO E (>y OR WHO HAS
WIT911,160%
ICo607( COMMISSIONNUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
A'4. /
TYPE OR PRINT NOTARY
ANDRIA M. SCHEELE
4�Y pVA��i
N&*#ublic •State of Florida
My Comm. Expires Feb 27, 2016
Commission # EE 166071
'"4 �f� ,•,, Bonded Through National Notary Assn.