HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
230D VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
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FILLED LAND AFFIDAVI
I, theundersigned, am the owner of the following described property,
glW FnP.1nl/P. 0I01P.
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.
Name (Please
Property
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Date
STATE OF FLORIDA, COUNTY OF :5 - [,V ` (I't
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ACKNOWLEDGED BEFORE ME THIS tom,,( DAY OF V��iaf/ t/i�20��
BY1110MCIS IV)I r VAy �I O�JP/HOISPERSONALLY KNOWN TOMEC1ORWHO HAS
PRODUCED L It I V -K I -) 1 1 1 AS IDENTIFICATION.
rr SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
GG a 6gWOMMISSION NUMBER
(SEAL)
�.y: Wj. Notary Public Stete d Florida
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Eyire111022SLCPDSD Revisd 04/12011