HomeMy WebLinkAboutFilled Land Affidavit F ; PLANNING &DEVELOPMENT SERVICES DEPARTMENT
- Building&Code Regulations Division
2300 VIRGINIAAVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
11,700 ' x- fooe--4. 0. 5 W 0 7
(Parcel Id#/LegAll 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.
V,92���-� �L�
JV S i 7A C-V S 16:'2
Pr7perty Owner Name(Please Print)
Property Owner Signature I/ Date
.'- - �J/ r -
STATE OF FLORIDA,COUNTY OF '
2AEDGED BEFORE ME TH DAY OF 20 /
t t
� ( WHO IS PERS AL KNOWN TO ME(�OR WHO HAS
41, ` AS IDENTIFICATION.
SIGNATURE F O P YPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
�;y'Pymt, AUDREY B.HUMPHREY
MY COMMISSION#FF 17477201
'"• j EXPIRES:March 6,2
iters
Bonded Thru Notary Public Underwr