HomeMy WebLinkAboutFilled Land Affidavit i
PLANNING&DEVELOPMENT SERVICES DEPARTMENT
COUNTY
Building&Code Regulations Division
• • I D A 2300 VIRGINIA AVENUE
FORT PIERCE,FI.34982-5652
(772)462-1553.
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
(Parcel I&/LWI descAption/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 Cade,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.,
Property Owner Name(Please t)
Property.bwner Signature Date
STATE OF FLORIDA,COUNTY OF
`1
ACKNOWLEDGED BEFORE-ME THIS DAY OF /. 20,9!kBY ,��I S'1 'WHO IS PERS ALLY LY
ME(ED)OR WHO HAS
11
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOTV PUBLIC V T 7-PR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011