HomeMy WebLinkAboutFilled Land AffidavitJ�
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, ark the owner of the following described property,
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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 > either obliged nor liable to provide for, or maintain in any form,
adequate drainage o''ff my property which will not adversely affect the immediate
community.
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PropWr Name (Please Print)
Property wner Signature Date
STATE OF FLORIDA, COUNTY OF /
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ACKNOWLEDGED BEFORE MtE THIS /1� DAY OF �/ Y ' 20 s ',
BY 9 , AO IS PERSONALLY KNOWN TO ME CE:1) OR WHO HAS
PRODUCED �R/V �) AS IDENTIFICATION.
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SIGNATURE OF TA PtJi LIC YPE OR PRINT N
NOTARY
COMMISSION NUMBER
i (SEAL)
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SLCPDSD Revised 04/11/2011 FIt"
t►IY?, AUDREYS. HUMPHREY
'*_. MY COMMISSIM # GG 300817
:d EXPIRES: March E, 2023
:F$d F��,".• Bonded Thru NoRaly Ptunc UndwAters