HomeMy WebLinkAboutFilled Land Affidavit 0
--- — 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,
3AP s-rl 01000g 000s
(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.
Y
Property Owner Name(Please Pri t)
Pr perty Owner Signature Date
7
STATE OF FLORIDA,COUNTY OF
ACKUQW. LEDGED BEFORE ME THIS l DAY OF �r 120
BY C WHO IS PERSONALLY KNOWN TO ME(—)OR WHO HAS
PRODUCED �7L_ AS IDENTIFICATION.
SIGNATURE OF NOTARY P LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
LASHAHNAINGRAM
Notary(RFjwtc)-State of Florida
My Comm.Expires Dec 20,2018
Commission #FF 177249
Bonded through National Notary Assn.
SLCPDSD Revised 04/11/2011 �` �