HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE 1`NNEp
FORT PIERCE, FL 34982-5652 SCE`
(772) 462-1553 cJt LUBB Cp11,Ot�
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel
i t! �
for which I have applied to St. Lucie County for a F' al Develop nt Permit. In
accepting this Final Development Permit, BP Number C= I acknowledge
that as owner of the above described property, and in accordahee 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 finther 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.
&,&V7 A- AeK d-
Prope Owner Name (Please Print)
11
Pr perty Own Signature Date
f {{11
STATE OF FLORIDA, COUNTY OF I 0(1,60
ACKNOWLEDGED BEFORE ME THIS 15 DAY OF
BY IR&N2J V 1 \ - r w &O WHO IS PERSONALLY KNOWN TO ME L—) OR WHO HAS
PUBLIC
SLCPDSD Reviud 0441/2011
(SEAL)