HomeMy WebLinkAboutFilled Land AffidavitJ
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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) Jr
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. L-ucie-C-ounty-is-neither-obliged-nor-liable-to-provide-foror-maintain-in-any-forrri�---
adequate drainage off my property which will not adversely affect the immediate
community.
0 erty Owner Name (Please Print
�: exyz z,
Property Owner Signature Datel
STATE OF FLORIDA, COUNTY O
PRODUCED
GED BEFORE ME THIS 61'2-1 DAY OF 20�,
/ ' DYYI -AW O IS PE ALLY KNOWN TO ME (El OR WHO HAS
COMMISSION NUMBER
AS IDENTIFICATION.
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TYPE OR PRINT NOTARY
(SEAL)
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SLCPDSD Revised 04/112011 MY COMMISSION 16GG 300817
EXPIRES: March 8 2023 ?L
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