HomeMy WebLinkAboutFilled Land Affidavit t , 1
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PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Ste:Lec
COUNTY---,,----
` g Regulations&Code Re lations Division
FLoR_ ioA - 2300 VIRGINIA AVENUE
_
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of thefollowing described property,
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(Parcel Id#/Legal description/ ress)
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
it WILL NOT be adverselyaffected.
adequate drainage so that the immediate community
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.
I mss . l'it,
Pr e• 9 O'fr• e Print '
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l operty Owner Signa r Date
STATE OF FLORIDA,COUNTY OF J, 10064.ce.
ACKNOWLEDGED BEFORE ME THISIDAY OF V e-4 20 /( , •
BY �7 r f ,` CI-Cut-/
WHO IS PERSONA �'Y KNOWN E(E)OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIG OF NO YLIC *if*PRINT NOTARY I..
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 ' m.Y I:
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:*? t + 1 EXPIRES:March 6,2019
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