HomeMy WebLinkAboutFilled Land Affidavit--t
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 follow escribed property,
(Parcel IM/Legs escription/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.
. P
Propelty Owner a Print)
Propertyweer Signature Date
STATE OF FLORIDA,COUNTY O IZJA
ACKNOWLEDGED BEFORE ME THIS �S�DA� �+'�� 20
BY ein WHO IS PERSONALLY KNOWN TO ME(El OR WHO HAS
PRODUCED �' I AS IDENTIFICATION. I
SIGNATUAEOF-Nd`9jPMQC IWPE OR VIT NOTARY
COMMISSION NUMBER
(SEAL)
"+t'• AUDREY B.HUMPHREY
.; .: MY COMMISSION#FF 174772
SLCPDSD Revised 04/11/2011 =. EXPIRES:March 6,2019
' PiPn Bonded Thru Notary Public Underwr tars