HomeMy WebLinkAboutFilled Land Affidavit PLANNING& DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
COUNTY
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the followin described property,
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(Parcel #/Legal d c tion/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number acknowledge
that as owner of the above described property, Ad" 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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Property Owner Name(Please Print)
AVroperty Owner Signature 'Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF /41'Y�I�/ 20 0
BY WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED ��/ AS IDENTIFICATION.
SIGNATURE OF NOTARY CDBLIC TYP OR MZINt NOT
SeJ!dk�uo i'Je9a�s
COMMISSION NUMBER sC �Z 00SSltu 0
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SE e�0!V-eP!j�SSlwwO
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77
SLCPDSD Revised 04/11/2011
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