HomeMy WebLinkAboutFilled Land Affidavit lS�� CTDItD
PLAN.NnG & DEVELOPMENT SERVICES DEPARTMENT
Buticllmg Code Regulations D."%ision
FORT PIERCE. FL =.3982-5652
FILLED LAND AFFIDAVIT
1. the undersigned. am the owner ofthe following described propertv.
(Parcel Id#/Legal description/Address)
for v hich I have annlied to St. Lucie ('oust\ for a Final Developmeni Permit. T",
accepting this Final Development Permit, BP Number I acknowvledRe
that as owner of the abo\e described propert\, and in accordance with SectiOE
7.04.0l(ll). St. Lucie Count\ Land Development Code. I shall he responsible for assurui�_
adequate drainage so that the immediate community WILL NOT be adversel\- affected.
1 further acknowledge that in granting this permit for the development of this property-.
St. Lucie CouniN is neither obliged nor liable to provide for. or maintain in any form_
adequate drainage off my property which will not adverse(- affect the immediate
communit".
Propert\ Own�'r Name(Please Print)
Propem Ox ner �)Ignaturc Date
S ATE OF,'� 1 (C!i-,`T.. a P S
�(NNU\ .EDOLD BEtOR:\IE THIS
tit 6f� \1 11U I�nrR l ,:\L_l KNok\1 TO\'F i C.-
PROD L t
nFtUDll t)_-_ _ /1!1 1, r►`v�}� L/C• -- -\S'DENTFICAT10\
A I LRE OF�,O \Rl PLBLIC TY! OR?R!\T\01 AR1 J
Cu\IMISSIO\ NLMBER
>D, LD S. NG
• Notary Public
COMMONWEALTH OF MASUCMUSET
My Carrrrission r,tp
SLCPDSD Re%ised u= 11 2011 2b. Y