HomeMy WebLinkAboutFilled Land Affidavit PLANNING& DEVELOPMENT SERVICES DEPARTMENT
COUNTY 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 followingdescribed property,
IlLo — — o1gn— 000—(R
(Parcel Id#/Legal description/Add sre s)
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 WELL 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.
Pro erty wn r Name(Pleiase Print)
Prope weer Signature Dale
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED
,BEFORE
�MEE THIS DAY OF
y
BY k C—Ik/. A WHO IS PERSONALLY KNOWN TO ME LDj OR WHO HAS
PRODUCED F-C AS IDENTIFICATION.
SIGNA rURE OF NOT4j PUBLIC TYPE OR PRINT NOTARY
O COMMISSION NUMBER
(SEAL)
auu�
D�pPYPUB� ELL EN VAUGNN
SLCPDSD Revised 04/11/2011 n `_State of F orida
Commission # GGarY Public
MY Commission EX70079
October 22, 2022�res
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