HomeMy WebLinkAboutFilled Land Affidavit PLANNING& DEVELOPMENT SERVICES DEPARTMENT
- Building&Code Regulations Division
2300 VIRGINIA gENUE
FORT PIERCE,FL 34982-5652
i (772)462-1553
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FILLED LAND AFFIDAVIT
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j I, the undersigned, am the owner of the following described property,
a� � ado ,qA � 1 ► 5� �f. ,E
(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 commuty 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 maintaip in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
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ert Pro r p y e Name(Please Print)
-202o
Property O r Signature Date
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STATE OF FLORIDA,COUNTY OF �� u
ACKNOWLEDGED BEFORE.TfE THIS DAY OF 0`4 amUu__ 120 �i{J
BY U' q WHO IS PERSON ALLY KNOWN TO ME LI OR WHO HAS
PRODUCED
AS IDENTIFICATION.
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C,00 � i tK
K mp 1 SIGNATURE OF NOTA1fY PUBLIC TYPE OR PRINT XOTAR.
COMMISSION NUMBER
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(SEAL)
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� ., .. JACQULIN
TroCyO fOrKlJ-6DMAItM IE RSLCPDSD Revised 04/11/201I COmmissig8 GG 12537=Expires Augu 8,20211 d
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