HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
61 - 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,
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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-
that
cknowledgethat 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 Owne ame(Please PrintV
er Signature Date
STATE OF FLORIDA,COUNTY OF —:r PIC–
ACKNOWLEDGED
I
ACKNOWLEDGED BEFOREMETHIS DAY OF 1204
BY r y OR( � 4- WHO IS PERSONALLY KNOWN TO ME L—)OR WHO HAS
P DED AS IDENTIFICATION.
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SIGNATURE OF N AR PUBLIC TYPE OR PRINT NO ARY
COMMISSION NUMBER
(SEAL)
Craig Emmette MaaCOY
NOTARY PUBLIC
STATE OF FLORIDA
SLCPDSD ReviComm#FF9W01
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