HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
• 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
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FILLED LAND AFFIDAVIT
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I,the undersigned, am the owner of the following described property,
700 c15��`�i� T Piece— le
(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 Name(Please Print)
P 9 e Owner ignatAe Date
STATE OF FLORIDA,COUNTY OF
ACKN WLEDGED BEFORE ME THIS DAY OF 20_[71_.
BY WHO IS PERSONALLY KNOWN TO ME(_)OR WHO HAS
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ADUCED AS IDENTIFICATION.
GNATURE OF NOTARY PUBL TYPE OR PRINT NOTARY
COMMISSION NUMBER
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(SEAL)
SLCPDSD Revised 04/11/2011 �,�aY��, LASHAHNA INGRAM
Notary Public State of Florida ,C
My Comm.Expires Dec`20,2018;
Commission#/FF 177249
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'.;'lilt `' Bonded through National Notary AsF