HomeMy WebLinkAboutFilled Lands Affidavitu
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGNIA AVENUE
FORT PIERCE, FL34982-5652 RECEIVED
(772) 462-1553
FEB 13
FILLED LAND AFFIDAVIT
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
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for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number aaaa.c53;lj 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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Property Owner Name (Please Print)
Prop ty Owner Signature Date
STATE OF FLORIDA, COUNTY OF Save) 7 4%z�- C-OUn /-x
ACKNOWLEDGED BEFORE ME THIS , 3 DAY OF `" I�I�� 20 a`n
BY Sae.>�D kit o f ic'1' 3 WEl LS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED \ L-1p L' AS IDENTIFICATION.
//SIGNATURE OF NOURY PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 04/112011
TYPE OR PRINT NOTARY
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