HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
• R I D 2300 V1RGRGA AVENUE
FORT PIERCE,FL 3082-5652
(772)462-1553.
FILLED LAND AFFIDAVU
I,the undersigned,am the owner of the following described property,
(Parcel Idt/Lepl 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 farm„
adequate drainage off my property which will not adversely affect the immediate
community..
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operty Owner N leas )
• � 28 c�-O`�l� •
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF ��
ACKNOWLEDGED BEFORE nME THIS I? DAY OF d + +� 20 '.
BY S��C�I7 )_C LQ h) O IS PERSONALLY KNOWN TO ME(�OR WHO HAS
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PRODUCED 1 l I L AS IDENTIFICATION.
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SIGNATURE OF NOTARY UtBLIC EOR NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 0411112011
AUDREY 8.HUMPHREY
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