HomeMy WebLinkAboutFilled Land AffidavitN®Tj PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
W6 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,
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all description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
ge
that as owner of the above described property, and in accordance lwith 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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Proper Omer Name (please Print)
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Property f� Jlgriatu ,
Date
STATE OF FLORIDA, COUNTY OF 4jt I LLB 1 t
ACKNOWLEDGED BEFORE JM�E THIS_t_ DAY OF T
BY—P- ('AAA IY.N _tAL3u.� T 20—�_
�. — WHO IS PERSONALLY KNOWN TO ME L&) OR WHO HAS
PRODUCED _
I� 1 11 `AS IDENTIFICATION
S NATUREOF NN rAR UBLIC s\1LNAQ� al JONN.{OM
TYPE OR PRINT NOTARY
GGo84aat COMMISSION NUMBER
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RICRARO DOUGLAS JORNSON
Wary Public-SU[e of Fltuida
SLCPDSD Revised 04/II/2011 ')•.My
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Comnssae/GG 084821
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Comm. Espiies MN 20.2021
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