HomeMy WebLinkAboutFilled land aff ,. PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
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FILLED LAND AFFIDAVIT
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I, the undersigned, am the owner of the following described property,
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(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 j
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.
/ J7.+�17 �!7
Property Owner Name ase P ' t
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF / �� //""''�8
ACKNOWLEDGED BEFORE ME JS / DAY OF 20
BY > WHO IS PERSONALLY OWN TO ME O OR WHO HAS
PRODUCE AS IDENTIFICATION.
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SIGNATURE OF NOT IC TYPE OR PR ITN I�e�23 A�
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CO ISSION ER m y o45� 5.
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SLCPDSD Revised 04/11/2011
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