HomeMy WebLinkAboutFilled Land Affidavit 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,
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(Parcel Id#/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.
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Prop OwnerName(Please Print)
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Property Owner Signatllre Date
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STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE
�METHIS (7'l DAY OF J&D C�l SL 120 7 1
BY �X 1.1 JCJ CC�1I t WHO 1S PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIGNAAT��UREj F NOTARY PUBLIC TYPE OR P NOTARY
FF 9c707 OMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 � Y p`�h Notary Public State of Florida
y A1s Cathy L Gaspar
,� My Commission FF 932735
Expires 12/08/2019