HomeMy WebLinkAboutFilled Land Affidavit PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division ''
• 2300 VIRGINIA AVENUE EC E I V E D
FORT PIERCE,FL 34982-5652
(772)462-1553
JAN- 17 2017
FILLED LAND AFFIDAVIT PERMITTING
St. Lucie County, FL
,j,.the undersigned, am the owner of the following described property,
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177
(Parcel Il#/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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Prope Owner Name(P ase Pt in
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Own Date
STATE OF FLORIDA,COUNTY OF to Cy
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ACKNOWLEDGED'BEFORE ME THIS z DAY OF v / ,20 1 9 ,
BY �` "�/ 0 l lJZ WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCE �'S O C O�n AS IDENTIFICATION.
SIGNA URE OF(�N�O� ' Y UBLIC TYPE OR PRINT NOTARY
� `7COMMISSION NUMBER
(SEAL)
O"PA
YPLO� NANCY HERRERA
Notary Public State of Florida
SLCPDSD Revised 04/11/2011Pc My Comm. Expires Oct 51 2017
:�'�` Commission #FF 049374
Bonded Throu h
9 National Notary Assn. '