HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT SC By
Building & Code Regulations Division
2300 VIRGINIA AVENUE St. LU
FORT PIERCE, FL 34982-5652 Luc COUnty
17711462 1553
FILLED LAND AFFIDAVIT
NOV 222011
BY........................
I, the undersigned, am the owner of the following described property,
0/0 -��a-
(Parcel 10ILegal descrip
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.
Property O me Please Print)
roq Owner Sij` tore Da[�
STATE OF FLORIDA, COUNTY OF ST LUCIE
ACKNOWLEDGED BEFORE ME THIS l I DAY OF {' N 0 (%E�4116'Z— , 20�,
BY 'li\Pi6 C4M4Q(ll WHO IS PERSONALLY KNOWN TO ME (El OR WHO HAS
SIGNATZR&OF'NOTARY PUBLIC
O'MI COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
Is•.•.w� MICHAEL TODD HOLCOMB
f ` MY C01r1 ASSION # GG107512
p EXPIRES May 23, 2D21