HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
COUNTY
Building& Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 RECEIVED
(772)462-1553
JAN I �,.202t
FILLED LAND AFFIDAVIT permitting,Department
St. Lucie County
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I,the undersigned, am the owner of the following described property,
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(Parcel d#/Le al description Addres
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.
Property Owner Name(Please Pr'
v
erty Owner Signature Date
STATE OF FLORIDA,COUNTY OF �1'
ACKNOWLEDGED BEFORE ME THIS DAY OF CY A ,20 ,
BY V)V,I �-- — WgiO IS PERSONALLY KNOWN TO ME CO)OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOT PUBLIC TYPE U I-AKY
6a-2 C MMISSION NUMBER
(SE
:2 sta ELLEN V
Co e of Florida Notary Public
SLCPDSD Revised04/11/2011mmission
October si9-9
on Expires
22, 2022
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