HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 Dec c�
(772) 462-1553
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FILLED LAND AFFIDAVIT Sit ecPva� j/�
I, the undersigned, am the owner of the following described property,
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for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number VgIV DIV11 , 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.
Prq a Owner Name Please Print) /
Prope O ter Sil nature //' �J Dale
STATE OF FLORIDA, COUNTY OF—(; - G�-�•.• t `-� ACKNOWLED EDBEF MET�H DAYOF df Or _.20
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�f/' t WHO IS PERSONALLY KNOWN TOME (� OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SLCPDSD Revised 04/11/2011
MY Comm. C�%nth May 1 • 7023