HomeMy WebLinkAboutFilled Land Affidavit r•
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PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
' 2300 VIRGINIA AVENUE
FLIRT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
3-7s® whwp y 6 P,
(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.
AJx
Property Owner Name(Please Print)
Property Owner Signature Date
STATE OF FLORIDA;COUNTY OF
ACKNOWLEDGED BEFORE ME'THIS � DA OF 20 1
BY II— �� ]�• .—J J (��—W p S AONALLY KNOWN TO ME CO)OR WHO HAS
PRODUCED ^ AS IDENTIFICATION.
(21 d )I
SIGNATURE OF NfARY PUBLIC t1PE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
A"' B.HUMPHREY
MY COMMISSION#FF 174772
,•. ,. EXPIRES:March 6,2019
SLCPDSD Revised 04/11 t201I BoededThruWary PubrcUndemrters