HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE =RECEIVEIDFORT 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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(Parcel IM/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.
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Property Owner Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF St Lucie
ACKNOWLEDGED BEEF -ORE ME THIS I q DAY OF Nnyern %1' , zo 1 ,
BY Ex rtJ arcl. IUYdIUh P4L)C7 WHO IS PERSONALLY KNOWN TO ME C )OR WHO HAS
PRODUCED -� AS IDENTIFICATION.
L' & PaulaS. Breier
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
&6703n8g3 COMMISSION NUMBER
Brew
a y C04mi 4 GG030843
-* '= Expires: September 15, 2020
Bonded tM Aaron Notary
SLCPDSD Revised 04/11/2011