HomeMy WebLinkAboutFilled Land Affidavit ,a,, PLANNING & DEVELOPMENT SERVICES DEPARTMENT
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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 fo�llloowing 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.
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Property weer Name(Please Print)
'/7
Property GAer Signature Date
STATE OF FLORIDA,COUNTY OF <VP
ACKNOWLEDGED BEFORM."';6 �j /ye DAY OF 20 / '
BY & erG r-/WHO IS PE ALLY KNOWN TO ME(_)OR WHO HAS
PRODUCEI5j / e AS IDENTIFICATION.
/�J)v� H. &
�16NATURE OF N ARY PUBLIC TVE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 0411 1/20 1 1
AUDREYB.HUMPHREY
*; MY COMMISSION#FF 174772
EXPIRES:March 6,2019
Bonded Thru Notary Public Unde rvRders