HomeMy WebLinkAboutFilled Land Affidavit i
7 PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
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 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(P ase Print)
Property Owner ignature Dat
STATE OF FLORIDA,COUNTY OF )
ACKNOWLEDGED BEFORE ME THIS I DAY OF 20 /
N
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BY ` `�d 1\IyI L# L."PERON LLY KNOWN TO ME(ElOR WHO HAS
PRODUCED J) OC dv I AS IDENTIFICATION.
SIGNATURE OF NOT UBLIC TYPE CU
PRINT NOTARY /
COMMISSION NUMBER
III
(SEAL)
SLCPDSD Revised 04/11/2011
RY Py°ti=- AUDREY B.HUMPHREY
* *: MY COMMISSION#FF 174772
P4 EXPIRES:March 6,2019
Af •• Bonded Thru Notary
;�4Public Underwriters