HomeMy WebLinkAboutFilled Land Affidavit RECEI'.' MAY 11 tQ
-- - PLANNING & DEVELOPMENT SERVICES DEPARTMENT
�: F
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,
a ciac4'c Ate',IleFee
(Parcel Id#/Legal description/Addd� r",essjk
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.
Property Owner Name lease Print)
Prop Owner Signature Date
STATE OF FLORIDA,COUNTY OfS,4
ACKNOWLEDGED BEFORE ME THIS��DAY OF / ��/ 20
BY �EA' EN L_L( I O ISPERSWN TO ME OR WHO HAS
PRODUCED 1J� � AS IDENTIFICATION.
VL�Q - / " V IT��
S GNATURE OF N TARP PUBL0IC TYPE PRINT NOTARY
COMMISSION NUMBER
(SEAL)
=o.sY^ygc, AUDREY B.HUMPHREY
MY COMMISSION#FF 174772
SLCPDSD Revised 04/11/2011 a EXPIRES:March 6,2019
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Bonded Thru Notary Public Underwriters