HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
• 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
Udo S Cep b r 7q-6
(Parcel Id#/Legal description/Address)
at
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number Q - CD I acknowledge
that as owner of the above described property, and 'in accor ance 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.
XCarol A;&r-M-
a
qty Owner Name(Please Print)
Property Owner ignature Date
'
STATE OF FLORIDA,COUNTY OF ir�-_
ACKNOWLEDGED BEFORE ME THIS Cis?I fV DAY OF .� � -20 1 ,
BY Q--',.Iry k 4-rI9 cyP1 WHO.PERSONALLY KNOWN TO ME OR WHO HAS
PRO D AS IDENTIFICATION.
J 1 �lv n
S NATURE OF NOTARY LIC TYPEIOR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 RENEE DELAHUNTY
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