HomeMy WebLinkAboutFilled Land Affidavit J till
PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT ('
I
I,the undersigned, am the owner of the following described property-
(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 communityWILL 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.
Property Owner Name(Please Print)
Property Owner Signature Date
r
STATE OF FLORIDA,COUNTY OF 6
4A�
ACKNOWLEDGED BEFO ME THIS DAY OF
BY_ II`, (� �� ' -WHO.IS PERSONALLY KNOWN TO ME L—)OR WHO HAS
ODUCED AS IDENTIFICATION.
SIGN TURE O TARY PUBLIC T R PRINT NOTARY
COMMISSION NUMBER
,aoi?ar ni NANCY MIMS ARMSTRO
°_ MY COMMISSION#FF197899
EXPIRES February 10,2019
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SLCPDSD Revised 04/11/2011 14o— a FtoddallotarySsrvice•cQ'T'
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