HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 =RECEIVED(772)462-1553
SCANNED FLED LAND AFFIDAVIT
BY
St. Lucie County
I, the undersigned, am the owner of the following described property.
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number 1 01—L3/% 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.
tali �51�,
Property Owne ame (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF
AC OWLS rED BEFORE METHIS 19 7h DAY OF n(. -pe�,
BY WHC ISPERSONALLY KNOWN TO ME(Id6I)OR WHO HAS
PRODUCED AS IDENTIFICATION.
(SEAL)
SLCPDSD Revised 04/1 M2011
99i
tate of Flodda
ahan FF 150355
018
no 3.033-"?
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION'
230O VIRGE-HA AVENLTE
FORT PIERCE,;FL 34582-5b5g
(772)d52-1553
FILLED LANDS AFFIDAVIT
L the undersigned, am the owner ofthe.following described property,
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,Co'dc, I shall be responsible for assuring
adequate drainage so that the immediate community Vff,U 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 Owner Na a lease Print)
3�/o
Prop" lgnature :Date
STATE. OF FLORIDA, COUNTY OF�/
tr OAYOF / / ICA/i/h - .20 1
ODUCED - --
-- AS IDENTIFICATION.
S GNATURE OF NOTARY PUBLIC
TYPE OR PRIlVI`NOTARY
- d3SYCOMMISSIONNUMB&
(SEAL)
Notary Pub k Stale of FfwWa
Helen K Hanrahan
'SLCPDSD
My commission FF 150355
Revised OV242010
Exph ex oa1162010