HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIkGMAAVENUE
FORT PIERCE,FL 34982-5652
(7 2}462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
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(Parcel Id#/L g r escriptionJAddress)
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�6is 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 hich will not adversely affect the immediate
community.
j�k0 ), Fe rs '
Property mer Name(Please Print)'
_'-AN\1JN 3.
Pr p Ov&r Signature Date
STATE OF FLORIDA,COUNTY OF_(
ACKNOWLEDGED BEFORE ME THIS � � DAY OF � � .20�
B k se r.�/ i° r r/, WHO IS PE O A KNOWNTO E C OR WHO HAS
PRODUCED ] AS IDENTIFICATION.
I &)D
SIG AT OF NO' LI E OR PRINT NOTARY SCF?!-
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COMMISSION NUMBER
(SEAL)
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AUDREY 81 HUMPHREY
MY COMMISSION#G�300$iT
SLCPDSD Revised 04/11/2011 r� ;•: ,
:Qt= EXPIRES.March$2023
Bonded Tiuu Notary Public Uwdweri Iters