HomeMy WebLinkAboutFilled Land Affidavit 05 0a0y 0
PLANNING&DEVELOPMENT SERVICES DEPARTMENT
c Building&Code Regulations Division
2300 VIRGINIA AVENUE'
FORT PIERCEi FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
h the undersigned, am the owner of the following described property,
(Parcel d#/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(1)), 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.
=o�pOaine(Please Print)
S- r7 17
Property Owner Signature Date
STATE-OF FLORIDA,COUNTY OF.
ACKNOWLEDGED BEF RE ME THIS AAW. DAY OF 30 ,
al ? WHO IS PERSONALL. OWN TOME'{ Z.OR WHO HAS
PRODUCE AS IDENTIFICATION.
`-Slei AR: LIC T PRINT NOTARY
COMMISSION NUMBER
AtW#.SMITH
WCOMMISSION#GG476%1
"= EXPIRES:June 23,2021 -
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SLCPDSD Revised 04/I W011