HomeMy WebLinkAboutFilled Land Affidavit PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
• FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
- o _ yea 00 r SL 9S a
(Parcel Id#/Legal description/Addres
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number 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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Property Owner Name(Please Print)
7
�Prbpe�owner Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF 20—ift,
f I
BY 1 I`�S S (fid? O IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED 1�Z AS IDENTIFICATION.
�IGNA�AJE OF-NOT-AKY PUBLIC TYPE OR PRINT O 1� j
OMMISSION NUMBER
ELLEN VAUGFiN
( State of Florida-Notary Public
+- Commission#GG 270079
My CommissionP2,
-i - Ex !res
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Oii��P` Octobef 28 202
SLCPDSD Revised 04/11/2011