HomeMy WebLinkAboutFilled Land Affidavit PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
RECEIVED
2300 VIRGINIA AVENUE
• FORT PIERCE,FL 34982-5652
(772)462-1553 FEB 01 2018
FILLED LAND AFFIDAVIT ST Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
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(Parcel Id#Aegal 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.
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PropertyO r N e(Please Print)
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Property 9Pnef Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLE ED BEFORE ME THIS DAY OF 20_a
BY ilkm WHO IS PERSONALLY KNOWN TO ME(_)OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIGNATURE
SSIGNA URE OF NO Y P LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
KAREN S. NIELSEN
Commission# FE 115637
3 My Commission Expires
SLCPDSD Revised 04/11/2011 %°`;` June 12, 2018