HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
NW FORT PIERCE,FL 34982-5652
(772)462-1553 RECEIVED
C PN"1
FILLED LAND AFFIDAVIT DEC 0 7 20 15
L EPERMITTING
St. Lucie County, FL
I,the undersigned, am the owner of the following described property,
3`1 l q <n c7 i n a rpo H
(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 ' 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,,, �-4 lz)r
PPropperty caner Name le se Print)
' Q'� Lc'-� — I—'�-'-7— 1
Property Owner'Signat&e Date
STATE OF FLORIDA,COUNTY OF / F
ACKNOWLEDGED BEF ME THIS_ DAY OF
BY I/ WHO IS PERSONALLY KNOWN TO ME(_�OR WHO HAS
PRODUCED t AS IDENTIFICATION.
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SIGNATURE OF XOTARPbUrc TYP OR PRINT NOTARY
OMMISSION NUMBER
KAREN S. NIELSEN
a°�pan
.+ s Commission# FF 115637
3y da My Commission Expires
OF FI �• June 12, 2018
SLCPDSD Revised 04/11/2011 "'� t"`