HomeMy WebLinkAboutFilled Lands AffidavitST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGMA AVENUE
FORT PIERCE, FL 34982-5652
772-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described
(Tax 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.
wep, off,
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF P O l 4
ACKNOWLEDGED BEFORE ME THIS ao DAY OF 20�
BY S • 16 - 7 �� WHO IS PERSONALLY &OWN TO OR WHO HAS PRODUCED
AS IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE 010Ig39 13 cOMMISSION NUMBER
(SEAL)
Notary FState of FloridaWilma
+� 3�
F Carter
My Cammission DD743993
yip ru
Expires 0223/2012