HomeMy WebLinkAboutFilled Land Affidavit PLANNING& DEVELOPMENT SERVICES DEPARTMENT
&W-619 I I�kql I"V�11 Building&Code Regulations Division
41___r____1_* . 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
RECEIVED
DEC 10 Tq
ST. Lucie County, PermittinE,
1,the undersigned, am the owner of the following described property,
(Parcel ld#/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 WELL 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.
Prop etty owner Name(Please Print
Property er Signature' Date
STATE OF FLORIDA,COUNTY OF N'%
ACKNOWLEDGED BEFORE ME TI-IIS V DAY OF 7 fi, 2C�
BY\) .WHO IS PERSONALLY KNOWN TO ME LD
OR WHO HAS
PRODUCED —AS IDENTIFICATION.
SIGNATURE OF NARY PUKE- _T_VPrn]z 12IALEAQIOD;i
DEANNA MARIE GIVENS
COMMISSION NUMBER
MY COMMISSION#GG 022023 11
EXPIRES:December 16,2020
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SLCPDSD Revised 04/11/2011