HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
COUNTY
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
CC
N01i 1
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ILLED LAND AFFIDAVIT
BY: ......................
I,the undersigned, am the owner of the following described property,
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(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 111 I-OG ola , 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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Pr p r Name(Please Print)
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Prop rty a Signa ure 6We
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME TIES �, DAY OF N O V 20 11
BY `P►C�;.y C.,)(\'/� WHO IS PERSONALLY KNOWN TO ME((a OR WHO HAS
PRODUCED L U �- AS IDENTIFICATION.
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SIGNATURE OF NOTAkY PUBLIC TYPE OR PRINT NOTARY
C 5A14 COMMISSION NUMBER
.",,; •., DEAN�7GNIE�Ns
MY cOMMISSiO 2023
�. EXPIRES:December 16,2020
Bonded Thr+hlotary Public Underwriters
SLCPDSD Revised 04/11/2011