HomeMy WebLinkAboutFilled Land Affidavit Md � PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
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FORT PIERCE,FL 34982-5652 -_ _
(772)462-15531=
FILLED LAND AFFIDAVIT JUL 2 1
PE!VAITTiNG
Si. Lucie County, FL
I,the undersigned, am the owner of the following described property,
�a� fMda�(s/� ereGU � Fe �cP , HIvc/S�.
(Parcel Id#/Legal description/Address)
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 Na a(Please Pr* t)
2 avw
Po Own Signature --D/e
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE qME THIS DAY OF )1 V 20 o
BY J 4V C WHO IS PERSONALLY KNOWN TO ME L—)OR WHO HAS
PRODUCED r /SAS IDEE.NT�IFICATION.
SIGNATURE OF NOTARY P LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
Q1F' ``.
KAREN S. NIELSEN
Commission# FF 115637
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My Commission Expires
�i�F OF GtOF
June 12, 2018
SLCPDSD Revised 04/11!2011