HomeMy WebLinkAboutFilled Land AffidavitPLANNING & 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,
(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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Property Owner Name (Please Print)
ignature
STATE OF FLORIDA, COUNTY OF 5t L. jLi e'
Date
ACKNOWLEDGED BEFORE M1 E� THIS 3 ( DAY OF rcfC � , 20-,�b,
BY WHO IS PERSONALLY KNOWN TO ME CO) OR WHO HAS
PRODUCED AS IDENTIFICATION.
OOFNOTARY PUBLIC
-- TYPPRINT NOTARY
6GgL 15t/1 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
KYLE ANDREW DUNN
Notary Public - State of Florida
Commission # GG 257549
•..,,or F`;:• My Comm. Expires Sep 11, 2022
Bonded through National Notary Assn.