HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
• 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
I
I { I
I
FILLED LAND AFFIDAVIT
i'
I
I,the undersigned, am the owner of the following described property,
I
(Parcel Id#/Legal description/Address) i
i
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number i, 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, ori maintain in any form,
adequate drainage off my property which will not adversely;,affect the immediate
community.
Property Owner Name(Please Print)
I
roperty Owner Signature Da
` I
STATE OF FLORIDA,COUNTY OF \
�
o i
AC OWLEDGED BEFORE M O`
THIS DAY OF I 20Ak
BY I WHO IS PERSONAL Y KNOWN TO ME;(�OR WHO HAS
qq�ODUCED N IAS IDENTIFICATION.
I
\' SIGWATURE OF NOTARV PUBLIC TYPE OR PRINT NOTAR
i
COMMISSION NUMBER
(SEAL)
LASNAHNA INGRAM I�
�_ Notary Public-
State oI Florida
SLCPDSD Revised 04/11/2011 ; * My Comm. Expires Dec?0,2018,y
Commission FF 1 17249 3
'' D`
Bonded through NationatNotaryAssn.
i
I I
I
I