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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,
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description/Add ress)
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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.
Pioperty Okmer Name (Please
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Prop er Signa Date
STATE OF FLORIDA, COUNTY OF ,IP7 .'
ACKNOWLEDGED BEFORE ME THIS 25Z— DAY OF G/ 20 02-
BY (&x rA L LK ) WHO IS PERSONALLY KNOWN TO ME Q OR WHO HAS
• I J L AS IDENTI,F11C�A.TION.
ARY PUBLIC TOE OR PRINT NOTARY
COMMISSION NUMBER
SLCPDSD Revised 04/11 /2011
(SEAL)
• � �% AUDREY B. HUMPHREY
20 •' ....Q(��
MY COMMISSION # GG 300817 r•
EXPIRES: March 6, 2023
*�°P Bonded Ttiru Notary Public Unde