HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICE D -P-ART----- --- - --
Building & Code Regulations Division
2300 VIRGINIAAVENUE
.. ._ _...,.. _.,.._._. FORT PIERCE, FL34982-5652
(772) 462-1553
SCBY EU FILLED LAND AFFIDAVIT
St. Lucie Count
I, the undersigned, am the owner ofthe following described property,
141 Q •'3�4 - CxDD l • o00.2
(Parcel Id#/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 , 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.
Properly er Name lease Print)
�`� 21(0
operty Own igrl re Date
_' . • STATE OF FLORIDA, COUNTY OF Y' LU C-'v Ip
~ S ACKNOWLEDGED BEFORE IETHIS n DAY OF V 0
n
By I I 1 OJ1/., LAI,a"� 1 /t X �G ? WHO IS PERSONALLY KNOWN TO ME ( OR WHO HAS
PRODUCED AS IDENTIFICAATION.
tOJOL R , 13 (5 RD
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
CONOMSION NUMBER
(SEAL)
0ii CALHOP
SLCPDSD Revised 04/I12011 '.ir_ i'otE 191842
bo6, 2016
✓»f emam0063Bf7018