HomeMy WebLinkAboutFilled Land Affidavit PLANNING &DEVELOPMENT SERVICES DEPARTMENT
o 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,
- Cc, .- 4 11 '1- 440-�
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Developpent 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.
r
Lbzle- r—
Pr;oeertyjbker Name'( le Print)
tf "S �p
4PrpDe?rlyOwner Signatur Date
STATE OF FLORIDA,COUNTY OF +�U C
ACKNOWLEDGED BEFORE ME THIS S DAY OF20�,
BY "T%No 4*4 S O�-4\� WHO IS PERSONALLY KNOWN TO ME L—)OR WHO HAS
PRODUCED L AS IDENTIFICATION.
V
SIGNATURE OF NOTAky PUBLIC TYPE OR PRINT NOTARY
�-- , IvOMMISSION NUMBER a�t°A"pEPNNA G�Vie o1 F1or�da
1c
PUe�r NoVat 1 F�S1 'SSS pe 85876p16
"C" ,:=My Gomcmn. . 11#EalNolacY NWA.
:6�.*o Com �on9hNahon
4rE OF p.
SLCPDSD Revised 04/11/2011