HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
2Building&Code Regulations Division
2300 VIRGINIA AVENUE
PMW FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFF it i f, �0 " I
WY .r.�
I,the undersigned, am the owner of the following described property,
LZ/L,Q.oV�
(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.
Ines
Property Owner Name(Please Prmt)
Prope weer S' atur Dat
e
STATE OF FLORIDA,COUNTY OF :
ACKNOWLEDGED BEFORE ME THIS 1 DAY OF \ IP♦YLU 1�Y11 20 I L ,
BY_I�S�l �C, � P� 5 leil/ WHO IS PERSONALLY KNOWN TO ME C—)OR WHO HAS
PRODUCED IV L+ AS IDENTIFICATION.
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SIGNATURE OF NOTARY PUBLI TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
KAREN S. NIELSEN
_ Commission#FF 115637
SLCPDSD Revised 04/11/2011 'soP My Commission Expires
�'.,,,�oFF�;.' June 12, 2018