HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
P. ® Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 RECEIVED
SCANNED JUN 2 8 pp?g
BY FILLED LAND AFFIDAVIT
St. Lucie County ST. Lucie County, Permitting
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 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 (PI Print)
1-24 (�✓ -ao 19
Pr�rty Owner Signature I
Date
STATE OF FLORIDA, COUNTY OF Zy)Cl, n6 Q.Je L.
ACKNOWLEDGED BEFORE ME THIS r�t7) DAY OF-�uOc 201q ,
BY x:i\C Yon `�kt`/1 WHO IS PERSONALLY KNOWN TO ME(0)OR WHO HAS
SIGNATURE OF NOTARY PI1�
GCS 1144'�S COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
IDENTIFICATION.
TYPE OR PRVT NOTARY
SHERYL DE=GG994
State of Flor
e Commissio
My CommJune
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