HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
o 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 Iditegat 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.
F6Wxa*t Moremaq
Property Owner Name Print)
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Property Owner Signature Date
STATE OF FLORID&COUNTY OF M A97W
ACKNOWLEDGED BEFORE ME THIS 30 DAY OF I'IITKV ,20
BY PUT�JAM M0,Ck)AlJ WHO IS PERSONALLY KNOWN TO ME( )OR WHO HAS
PRODUCED r-- p L-.A4(--5.S-�//,S-64 3117- 7 AS IDENTIFICATION.
-. DORE
SIGNATURE OF NOTAR U C O T �1 SSI0N#FF 928213
,•••;oP= EXPIRES:January 3,2020
COMMISSION NUMBER 4f Fr• Bonded Thru Notary Public Underwriters
(SEAL)
SLCPDSD Revised 0411 1/20 1 1
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