HomeMy WebLinkAboutFILLED LANDS AFFIDAVIT PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building &Code Regulations Division
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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,
(Parcel Id#/Legal descriptin/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.
Re-r02 C.0 cl, T-2 r n 1'9
Property Owner Name(Please Prr )
1
Property weer Si ature Date
STATE OF FLORIDA,COUNTY OF
ACKN ES�D(GEE�D BEFORE ME THIS _DAY OF - 20�
By CJ �,� ONALLY KNOWN TO ME L_-)OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF OTARY PUBLIC "YPEORT NOTVY
COMMISSION NUMBER
(SEAL)
ANGELA M HUFF
;ao�oRY n�<<{; Notary Public-State of Florida
41 Commission#FF 234730
SLCPDSD Revised 04/11/2011 (d ," °�; My Comm.Expires May 27,2019
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Bonded through National Notary Assn.