HomeMy WebLinkAboutFilled Land Affidavit -- - - FLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building &Code Regulations Division
2300 VIRGINIA AVENUE FORT PIERCE,FL 34982-5652 E E I
(772)462-1553
MAR 1'7 2.017
FILLED LAND AFFIDAVIT PERVAITT11liG
St. Lucie County, FL
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 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.
64D/-rWqa--gt0�)
Pro erty Owner Flame(Please Print)
r
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS 14 DAY OF ' ' `w 20
BY�c[ e�cg_ 1 �� WHO IS PERSONALLY KNOWN TO ME CX OR WHO HAS
ODUCE AS IDENTIFICATION.
14—kvw-0 Iz- b 4 \
SI ATURE OF NOTARY PUBLIC TYPI ARY
COMMISSION NUMBER
ROCHELLE A. DURYEA
*` MY COMMISSION#FF004610
9rFOF'tti�P EXPIRES April 4,2017
SLCPDSD Revised 04/11/2011 (407)398.0153 FlorldallotarySBNiCO.00m