HomeMy WebLinkAboutFILLED LAND AFFIDAVITr --
RECEI"=D SEP 2 8 2016
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 SCANNEL,
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
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(Parcel Id#/Legal description/Address)
BY
St. Lucie Count,
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number LIeOS —ojf`� 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.
P�ro@ny Owner Name (Please Print) Q I� Q //�t,,
roper Signature Date
STATE OF FLORIDA, COUNTY OF ��Wlde G/ P/ )C
ACKNOWLEDGED BEFORE ME TIIJE�Srt a RA DAY OF 2QjJ�,
YfA BY rah, E �( / /�e✓- WlIO IS PERSONALLY KNOWN TOME L� OR WHO HAS
IDENTIFICATION.
U�y��IC /1/l a��/a 7Q�bP. ✓�
SI�N'�A OF NOTARY PUBLIC TYPE OR PRINT NOTARY
r� q/Z50MMISSIONNUMBER
MARCIA rAIBE� pT�
Wolvy Public - Stale of Runde
Commission N FF 941785
My Comm. Expires Mar ill, 2020
SLCPDSD Revised 04/11/2011