HomeMy WebLinkAboutFILLED LANDS AFFIDAVITPLANNING & 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,
3.5- 701 - oo3l-obn- S
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Develop ent Permit. In
accepting this Final Development Permit, BP Number 1402.- 01 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.
Rl,me ( G. Aced
Property Owner Name (Please Print)
�A- &.a 3l19l10-/
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF 6 (,tA �
ACKNOWLEDGED BEFORE ME T�HIS(, V` DAY OF MkrdA 2020j,
BY kYA"l 6 • r��- WHO IS PERSONALLY KNOWN TOME 1/ OR WHO HAS
AS IDENTIFICATION.
G.
[ A 'UREOFNOTAlf PUBLIC
TYPE OR PRINT NOTARY
COMMISSION NUMBER
\lylly,
"w°., LAURIE C. SWER
��. : �@ Notary Public • Slate of Florida
:o My Comm. Expires Aug 1, 2017
SLCPDSD Revised 08/24/2010
%'.,'For.• Commission N FF 011017
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