HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
RECEIVED
FILLED LAND AFFIDAVIT A U G 0 q , i'i
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following de cribed property,
(Parcel
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.
Prop ame (Please Print)
Pr a "er Signature Date----'
STATE OF FLORIDA, COUNTY OF [JI V'en-i
ACKNOWLEDGED BEFORE ME THIS �_ DAY OF rSLI S4 20 1
(
BY _ L \V) WHO IS PERSONALLY KNOWN TO ME - OR WHO HAS
PROD CED� D L- AS IDENTIFICATION.
GUAI LJ1I ea, c4
IGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
;.otia p� LUCYWHEATLEY
v?; Notary Public -State of Florida
Commission a GG 194104
°o.� F� My Comm. Expires Jun 29, 2022
SLCPDSD Revised 04/11/2011 """Bonded through National Notary Assn.