HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 6I.AMNtL
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
Do0/ o
Id#/Legal
BY
St. Lucie Count,
for which I have applied to St. Lucie County for a Final Develo ment Permit. In
accepting this Final Development Permit, BP Number 170 y- P 06 C , 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.
y� 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.
'l /',er,, LaIeE 09Y.V LGe/a� c-Fdo_ c/
Property Owner Na a (Please Print)
G a l�
Pr erty Ow r Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS d � DAY OF J` LkVN P , 20_�, _2,
BY Aft• rI QUA 1Q, WHO IS PERSONALLY KNOWN TO ME (ElOR WHO HAS
PRODUCED
nn 1 ��%%(���� lUu— C'( ��rS �C—t \& � A AS IDENTIFICATION.
.IM'L/0m lei • �J� SUs'R1\ A - 60(.ueN
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
F-7t< a 3 / 0� a COMMISSION NUMBER
(SEAL)
SUSAN A. BOWENSLCPDSD
Revised 04/11/2011
Publlc •State of Floridamission
mHid
# FF 231072mm.
Expires Jul 28, 2019