HomeMy WebLinkAboutFilled Land Affidavit a
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PLANNING&DEVELOPMENT SERVICES DEPARTMENT
CDUNTY
Building&Code Regulations Division
• 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the and rsigned, am the owner of the following described property,
6
(Farce d#/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.
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erty WvnerName(Please Print
erty Owner Signature Date 10
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE METHIS _DAY OF 20 y
BYVLWHO IS PERSONALLY KNOWN TO ME(l OR WHO HAS
PR UCED AS IDENTIFICATION.
SIGN OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
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SLCPDSD Revised 04/11/2011
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