HomeMy WebLinkAboutFilled Land Affidavit PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 ,Saar i�� E D
(772)462-1553
MAR 1 4 2012
FILLED LAND AFFIDAVIT
PERMITTING
St. Lucie County, FL
I,the undersigned, am the owner of the following described property,
&7rq /:I 6kn!,
(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.
'Pr erty Owner Nam ease Print)
r perty Owner Signa r Date
STATE OF FLORIDA,COUNTY OF-, . Lt1 cc
AC1q1OWLEDGEDBEFOREMETHIS 11// _DAYOF no*1K) 20
By T� WHO IS PERSONALLY KNOWN TO ME�)OR WHO HAS
PRODUCED •L' AS IDENTIFICATION.
SIGNATURE OF NOTARY PfJBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
���ppA�� EN S. NIELSEN
��om ission 1i FF 115637
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= My Commission Expires
„OFF June 12 2018
SLCPDSD Revised 04/11/2011