HomeMy WebLinkAboutFilled Land Affidavitso
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PLANNING -& DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
fo 7 tl / S be 45�w Ole
(Parcel Id#/Legal description/ ess
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.O4.O1(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.
• ej-oS �IOLi R
Property wner Name (Please Print)
P erty Owner Signature t
STATE OF FLORIDA, COUNTY i
ACKNOWLEDGED BEFORE ME THIS DAY OF 20
BY I WHO IS PERSONALLY VOWN TO ME OR WHO HAS
PRODUCED jQ AS IDENTIFIC)ATTION.
SIGNATURE OF VARY PUBLIC PT P OR PRINT NOTARY !
COMMISSION NUMBER
SLCPDSD Revised 08/24/2010
(SEAL)
41�y "X
;* AUDREYB MpyREy
+= MY COMMISS
: ION # EE 061159
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Bonded P'FThr1 ' March 6, 2015
YPublic Underwriters