HomeMy WebLinkAboutFilled Land Affidavit I
-- - - PLANNING & DEVELOPMENT SERVICES DEPARTMENT
e " Building & Code Regulations Division
2300 VIRGINIA AVENUE
- C F Ie"f
FORT PIERCE,FL 34982-5652
(772)462-1553
APR 10 201
FILLED LAND AFFIDAVIT
St. Luc;-,
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I,the undersigned, am the owner of the following described property,
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(Parcel I WLegal 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 11
community.
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CAUL
Property Owner Name(Please Print)
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Pr(TperAy Owner Signature Dale
STATE OF FLORIDA,COUNTY OF l {i�
ACKNOWLEDGED BEFORE ME THIS DAY OF U 1 GU1 eJ— 20 f /
BY C&XOI c�p,rlY�s WHO IS PERSONALLY KNOWN TO ME( j OR WHO HAS
PRO U ED AS IDENTIFICATION.
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GNATI OF NOT Y UBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBI(�
�° FARA D HERNANDEZ
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• MY COMMISSION#FF172419
EXPIRES October 28,2018 j
(407)398-0153 FloridallotaryService.com
SLCPDSD Revised 04/11/2011
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