HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT SGPN�E®
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I, `h ,r,,j C , hre�owner of the following described property,
(ParcelId#/Legal
for which I have applied to St. Lucie County for a Final DevelopiRent Permit. In
accepting this Final Development Permit, BP Number — QLA (314 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 father 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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�co-p" eTy=Own_ 'Nam��P� Prmg
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Troperty Owuei< ig �e Date
STATE OF FLORIDA, COUNTY OF 15-C. U )CkG
ACKNOWLEDGED BEFORE ME TIES �� DAY OF --NI V—tL. ,20 lO
BY M 1C':i-iLt1;L 6PcI„l'41� WHO IS PERSONALLY KNOWN TO ME ( OR WHO HAS
PRODUCED
h11T 13ri7 i
SLCPDSD Revised 04/11/2011
IDENTIFICATION.
6k\1P-170A is,. —
TYPE OR PRINT NOTARY
(SEAL)
ice' pro, SHIRLEY A. SAUNIER
Notary Public - State of Florida
• ; ° ` My Comm. Expires Jan 31, 2017
Commission # EE 861169
Bonded Through National Notary Assn.