HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300
FORT VIR INI AVENUE
N E -"'C E�I��� D
(772)462-1553
MAS 2 8'2016
FILLED LAND AFFIDAVIT PERMITTING
St. Lucie County, FL
I,the undersigned, am the owner of the following described property,
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(Parcel Id# egal description/A dress)
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.
Prope Owner Name(Please Print)
party Owner Sign a ate
STATE OF FLORIDA,COUNTY OF_,:!G j Q/
ACKNOWLEDGED BEFO,R/E�ME THIS DAY OF
BY motor,S ]C% r�I i WHO IS PERSONALLY KNOWN TO ME C__)',OR WHO HAS
PRODUCED L AS IDENTIFICATION.
�� - reel 5 �iC ISE _
SIGNATURE OF NOT Y PUBLIC TYPE OR PRINT NOTARY
Ffil FD 14:; COMMISSION NUMBER
_ (SEAL)
KAREN S. NIELSEN
x Commission# FF 115637
N
a� My Commission Expires
'�',�F OF F�O�•\� June 12, 2018
SLCPDSD Revised 04/11/2011