HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
• LIN Building&Code Regulations Division
_ 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
I
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
sj Ca
I( (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.
Propertl
Owner Name(PI ase Print)
Prope wner Signa Date
STATE OF FLORIDA,COUNTY OF /
ACKNOWLEDGED BEFORE ME TH�IISS��'�DAY OF / 0 V 20A_
BY t�,-l?4I A bL L�� WHO IS PERSONALLY KNOWN TO ME{ OR WHO HAS
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PRODUCED AS IDENTIFICATION.
SIGNATURE OF NO Y PUBLIC �TYPVR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011