HomeMy WebLinkAboutFilled Lands Affidavit ST.LUCIE COUNTY
BUILDING &ZONING
2300 VIRGINIA AVENUE
® FORT PIERCE,FL.34982-5652
a o 772-462-1553
FILLED-LAN-D AFFIDAVIT-- -- - -- -
I,the undersigned, am the owner of the following described property:
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(Tax ID/Legal descncpion/L dies!&:,
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 mer 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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Property Owner Name Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF -
ACKNOWLEDGED BEFORE ME l,T�HIS DAY OF 20 !"
BY �" �`� WHO IS P SO ALLY KNOWN TO ME OR WHO HAS PRODUCED
_C1l AS IDENTIFICATION.
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SIGNATURE O OTARY TYPE OR PRINT NAME OF POOTARY
(SEAL.)
NOTARY PUBLIC TM-E COMMISSION NUMBER
AUDREYB.HUMPHREY
MY COMMISSION#FF 174772
rg�%i EXPIRES-March 6,2019
3 .•�} u' Bonded Thar Notary public Und2nvdCers