HomeMy WebLinkAboutFilled Land Affidavit �� - PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
• 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
RECEIVED JUL 24"2015 FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
�3a �- qty - zSa55-�Q0� �
(Parcel Id#/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 15 07-031 a , 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.
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Property Owner Name(Please Print)
_� M.,eO' -1 ( a�-A 1 S
Property Owner Signature Date
STATE 1 FLORIDA,COUNTY 017_'S_1
ACKNOWLEDGED BEFORE ME THIS a 1 DAY OF
BY WHO IS PERSONALLY KNOWN TO ME L_)OR WHO HAS
PRODUCED rr L ID t' AS IDENTIFICATION.
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SIGNATURE OF NO Y PUBLIC TYPE OR PRINT NOTARY
6 A COMMISSION NUMBER
DEANNp GIVENS
State 01 Florida
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SLCPDSD Revised 04/11/2011