HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building &Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553 RECEIVED
1
FILLED LAND AFFIDAVIT [:AU:G1H ?0'3-
ST. Lucie count�y, Perrnitting
1,the undersigned� am the owner of the following described property,
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(Pare'eTIMLegal descriotion/Addr�ss) %
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.
$'roperty-0w;er 14-ame(Please Print)
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Property Owner Signature Date'
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE METHIS DAY OF 120
WHO IS PERSONALLY KNOWN TO ME CEI)OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIGN=AT �&F ��� TYPE OR PRINT NOTARY
a4.s<�(,N COMMISSION NUMBER
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C&OtSION#GG 022023
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SLCPDSD Revised 04/11/2011