HomeMy WebLinkAboutFilled Land Affadavit 0 0
PLANNING & 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,
-2 y!!� q /-P e Ids J-) ; v< Po r-f S-1 L 46 C 3Wff4
(Parcel Id#/Legal descri ion/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.
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Pr er Name(Ple rint)
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Property Owner Sign Date
STATE OF FLORIDA,COUNTY OF
AC OWLEDGED BEFORE ME HIS_-(!�DAY OF ` 20
By S LLY KNOWN TO ME(__)OR WHO HAS
a
UCED AS IDE'NTIIFICATION.
SIGNATURE I
NOTARY PUBLIC TYPE OR PAINT
N TARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 ANGELA M HUFF
•i►a�Pie%•.
Notary Public-State of Florida
41 • Commission#FF 234730
My Comm.Expires May 27.2019
%° ��' Bonded through National Notary Assn.?'