HomeMy WebLinkAboutFilled Land Affidavit 09/03/2015 13:21 #6808 P. 002/002
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PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGDla AVE eM *
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
1,the undersigned, am the owner of the following described property,
1430— 331— 0000— 000 f S
(Parcel 10fLegal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number 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 MUT 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 ray property which will not adversely affect the immediate
community,
In'401-yo M/ox
Property Owner Name(Please Print)
OP aftwe Date
STATE OF FLORMA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF -�V7twxS&P—
BY MPVL-\11J MIA)IX WHO Is PERSONALLY KNOWN TO ME CL-'j OR WHO HAS
PRODUCED AS IDENTMCATION.
VIR
SIGNATURE Of NOTARY PUBLIC TYPE OR PRINT NOTARY
0 COMSSION NUMBER
(SEAL)
SLCPDSDRevised 0411It2011. CYNTMABAUR
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WIRES:Jame 29.2019