HomeMy WebLinkAboutFILLED LAND AFFIDAVIT� yo-�- 7
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGESTIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
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FILLED LAND AFFIDAVIT &Y
106 Cotlrlt
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1, the undersigned, am the owner of the following described property,
M25-132-00/0-000-1 1051) PlcAlopzald R&W F-J.
(Parcel ld#/Legal description/Address)
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(1?), 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 -Owner Name (Please Print)
CTbmer Sig0kture
STATE OF FLORIDA, COUNTY OF S� LU611��
ACKILUWLEDGED BEFORE LAE THIS 7 d841% -Z DAY OF 20 If
BY� o . PERSONALLY90WN TO hIE (9 OR WHO HAS
'Mr, 1W -(I I
T
wAAr j�T YIPUBLIC T E 4Y
Co:� SSION NUMBER
(SEAL)
SLCPDSD Revimd 04/11/2011
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