HomeMy WebLinkAboutFilled Land Affidavit i
I PLANNING & DEVELOPMENT SERVICES DEPARTMENT
o 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)
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.
Property O ame(Please Print}
Pr erty Owner Signature Date
STATE OF FLORIDA,COUNTY OFF
ACKNOWLEDGED BEFORE ME THIS�_DAY OF 20 C fo
BY I e T_ &(J�ws WHO IS PERSONALLY KNOWN TO ME(3)OR WHO HAS
P DUCED AS IDENTIFICATION.
IG AT RE OF NOTARY P IC Q TYPE OR PRINT NOTARY
COMMISSION NUMBER
� f n
r o "YP°�, IAS EAL)
H HN4INGRAM-RAHMING
*; MY COMMISSION#GG 275060
' LOC
EXPIRES:December 20,2022 I
Bonded 111-ftuy Public Uncle twr'lots
SLCPDSD Revised 0411 1/20 1 1