HomeMy WebLinkAboutFILLED LAND AFFIDAVITR E C E I V 7 D 3 A N 2 1 7L,7
�PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
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2300 VIRGINIA AVENUE
FORT PIERCE. FL 34982-5652
(772) 462-1553
SCANNED
BY
St. Lucie County
FILLED LAND AFFIDAVIT
1, the undersigned, am the owner of the following described property,
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for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number ll//-.O� , 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.
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Property Owner Name (Please Pr t)
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Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF fiv/ AIl/Zt'--
ACKNOWLEDGED BEFORE ME THIS 16 DAY OF V�/ZCCLtsy IN
BY A / r-r�u u- EF�/ wrm WHO IS PERSONALLY KNOWN TO ME C OR WHO HAS
PRODUCED
IDENTIFICATION.
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SIGNATURE OF NOTAIUr PUBLIC
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TYPE OR PRINT NOTARY
(� gyy372 COMMISSION NUMBER
Ll Heidi A. Gpdarw
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NOTARY PUBLIC
STATE OF FLORIDA
COMM# FF944372
SLCPDSD Revised 04/1 I/201 I
Expires 12/16/2019