HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
n X016 FILLED LAND AFFIDAVIT
RECE��,,rp 5�10� l o
I,the undersigned, am the owner of the following21rc-'e described property,
8�q � 40--.-h' - ..Cour! G , 3 q7
(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.
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Pro weer Name(Please Print)
l 1-18.2oj�o
e S' ure Date
STATE OF FLORIDA,COUNTY OF2-,�• L,rc,%Ilk-
ACKNOWLEDGED BEFORE\\ME THIS d DAY OF OJ 20 `6
BY *4N'N t \d Q ��dq WHO IS PERSONALLY KNOWN TO ME I—)OR WHO HAS
PRODUCED L `' AS IDENTIFICATION.
' Q k'a r ra �i d Qy1S
SIGNATURE OF NO' Y PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
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Z' - MARIE GIVENS
Z' i._. MY COMMISSION#GG 022023
EXPIRES:December 16,2020
o��o?' BondedThtuNOWYPubI-Underwriters
SLCPDSD Revised 04/11/2011