HomeMy WebLinkAboutFilled Land Affidavit ANN
ING & DEVELOPMENT SERVICES DEPARTMENT
• Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
1,the undersigned, am the owner of the following described property,
19ZO ZO vZ PA)M h>r
(Parcel ld#/Legal discrilition/A41Less)-,>
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
7.04.0 1(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
'ffrCoYE i2l E.t?
Property Owner Nam(lease Print)
/v/-.16.
Property O � --5-a-te
STATE OF FLORIDA,COUNTY 0
ACKNOWLEDGED BEFORE/ME THIS DAY0 20/_(C
B Y 11A
MA WHOISP; NALLY KNOWN TOME L--)ORWHO HAS
PRODUCED I , AS IDENTIFICATION.
IGNATURE NOTARY I )BLIC TYP OR PRINT NOT Y
—COMNIISSION NUMBER
(SEAL)
AUDREYB,HUMPHREY
SLCPDSD Revised 04/11/2011 My COMMISSION#FF 174772
EXPIRES:March 6,2019
30"cled Thru Notary Public Underw*rs