HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT MAR 2 1 2017
PERMITTING
Sit. Lucie County, FL
I,the undersigned, am the owner of the following described property,
�Ho3 RAi/✓12EE SAIL F i2CE FL N- �1002,
(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 1 , 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 I'd t)
Property Own r Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED/BEFO METHIS DAY OF ,20BY 1 (� WHO IS PERSONALLY KNOWN TO ME(_)OR WHO HAS
PRODUCED (�. I AS IDENTIFICATION.
SI T NOTARY PUBLIC TYPE OR PRINT NOTARY
Om COMMISSION NUMBEL
I<AREN S. NIELSENCommission ,t FF 1 WWW)My Commiss on ExpiresJunE 12, 2018
SLCPDSD Revised 04/11/2011