HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 RECE-1VED
(772)462-1553
FILLED LAND AFFIDAVIT
DEC 0 4.2020
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
3403-502-0224-000-3
(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.
Property�er Name (Please Print)
roperty Owner Signature ate
STATE OF FLORIDA, COUNTY OF � , ll.yW'
ACKNNOOW�LEDGED BEFORE fMI o
E THIS I � - DAY OF _ I I J��C.�VYIIJP�Ii 20 ,
BY J a(-& `I 1�, l&. SOL_ WHO IS PERSONALLY KNOWN TOME 0 OR WHO HAS
P ODUCED
'SIGNATURE OF NOTARY PUBLI
,"S9qUIdGOMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
SABRINA L. BLACK
TYPE OR PRINT NOTARY
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• y #GG 289862
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