HomeMy WebLinkAboutFilled Lands AffidavitPLANNING & DEVELOPMENT SEI2VICFS DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
I, the undersigned, am the owner of the following described property, j
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(Parcel Id#/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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Propety Owner Name (Please Print) k—
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Propert Owner Signature Date
STATE OF FLORIDA, COUNTY OF � /-0 C_' �'_
ACKNOWLEDGED BEFORE ME THIS DAY OF 20
BY d sn � / {J_WHO IS PERSONALLY KNOWN TOME (®) OR WHO HAS
PRODU D
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SIGNATUR F NOTARY PUBLIC
SLCPDSD Revised 04/11/2011
COMMISSION NUMBER
TYPE OR PRINT NOTARY
=oiPPY`PUgic RHOWAS ROWE
* Commission # GG 104656
Expires May '19, 202'
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Bonded IhruBudget NotorySor"s
(SEAL)
AS IDENTIFICATION.