HomeMy WebLinkAboutFILLED LAND AFFIDAVITSCANNED
St. Luce County
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
y4a5--701-0o3l-oOo-5
(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 Ig020ALit , 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.
P-AASsel I Cam. geeaQ
Property Owner Name (Please Print)
4;vvle '4� /j-'ec2 3/l4 //y
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF &h-1'Pi
ACKNOWLEDGED BEFORE ME THIS I lqf- & DAY OF / A&4,&A' , 20 W
n,
BY I \ 06C elj 6 . � WHO IS PERSONALLY KNOWN TOME V//OR WHO HAS
PRO UCED AS IDENTIFICATION.
TrURE OF NOTARY TYPE OR PRINT NOTARY
�I"1 COMMIS ION NUMBER
�;i"'r" "••• (SILAURE C. SNYDER
• ; cs Notary Public - State of Floddat
• ' ` My Comm. Expires Aup 1 2017
•,,;•„l ��� •• Commission N FF 00047
SLCPDSD Revised 08/24/2010