HomeMy WebLinkAboutFilled Land Affidavit , ., PLANNING&DEVELOPMENT SERVICES DEPARTMENT
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,
'm 6 52, L"-n.
(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 wner Na e( lease Print)
Property er Signature Date
4 STATE OF FLORIDA,COUNTY OF
�
j�v
ACKNO EDGED BEFORE ME THIS—,/'& - DAY OF 20 / 7
By (/ ! /Com! WHO IS PES ALLY KNOWN TO ME U OR WHO HAS
YIfGNAT
C AS IDENTIFICATION.
��e(2A,/ E.
�
URENO ARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 AUDREY B.HUMPHREY
MY COMMISSION#FF 174772
:• ,, EXPIRES:March 6,2019
Bonded Thru Notary Public Underwriters
OF�„••