HomeMy WebLinkAboutFilled Land Affidavit PLANNING &DEVELOPMENT SERVICES DEPARTMENT
• MOLIN Building&Code Regulations Division
• 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
1,the undersigned, am the owner of the following described property,
M��21 _5�>qill -14,2 61-A
(Parcel ld#/Legat 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, ormaintainin any form,
adequate drainage off my property which will not adversely affect the immediate
community.
Property Oer I$Ae(Please Print)
PiKp9rty94iie_r Signature Date
STATE OF FLORIDA,COUNTY OF
BEFORE DAY OF ME THIS .20
BY WHO IS PERSONALLY KNOWN TO ME(a OR WHO HAS
PRODUCED br, AS IDENTIFICATION.
FLr0-J1Z- 36AA—Uptiv
SIGNATURE OF WARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
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Ts' My Comm Exoires Oct 9.2021
SLCPDSD Revised 04/11/2011