HomeMy WebLinkAboutFilled Land Affidavit i
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"OWN .
PLANNING&DEVELOPMENT-SERVICESDEPARTIVIENT
. BUILDING&CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
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FILLED LANDS AFFIDAVIT
I,the undersigned, am the owner of the following described property,
(Parcel IM 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.
T
Property Om ier Name(Pleas )
4�-
operty - S' {. Date
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STATE OF FLO A,COUNTY OF
AC'KIVOWLED ,EFORE ME THIS DAY OF 20��
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BY —XJV� '� WHO IS PERSONALLY KNOWN TO OR WHO HAS
PRODUCED AS IDENTIFICATION.
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GNATURE O LTC TYPE ORPRINT NOTARY
COMMISSION NMIBER
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(SEAL)
BARM A GOODM AN
* * W COMMISSION 9 FF 101341
EXPIRES:Merck 14 2018
SLCPDSD ReAsed OSJ24/2010 _V"',140 Bonded7�NBudgetNdaryServices
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