HomeMy WebLinkAboutFilled Land AffidavitPLANNING & 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,
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(Parcel Id#/Legal description%Address) / , 1cq, nd1
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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 Deve'llopment 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.
Date
STATE OF FLORIDA, COUNTY OF S - , , C- - -e--
ACKNOWLEDGED BEFORE �ORE ME THIS p �DAY OF J G-111 , , 20 ,
BY 5AVQ 0-wa <GCd UIQX� cu WHO IS PERSONALLY KNOWN TO ME p OR WHO HAS
PRODUCED (iO1�� (n 3 Ln �� 3�' i, o'� ��C7 AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC
662674,13 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
Va 1 n L. i6A J e
TYPE OR PRINT NOTARY
i.0 Not�aryPu lic State of Floiida
Valerie L Barden
lwy Commission GG 268813
�t Expires 10/17/2022
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