HomeMy WebLinkAboutFilled Land Affidavit�JL�E CMG ST. LUCIE COUNTY
- BUILDING & ZONING
N�b 2300VIRGINIAAVENUE
'x FORT PIERCE, FL 34982-5652
F�ORI�Q 462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
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for which 1 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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Property Owner Name Property Owner Signature Date
STATE OF FLORIDA. COUNTY OF.
ACKNOWLEDGED BEFORE ME THIS DAY OF , 20 v(1
BYWHO IS PERSONA Y N TO ME O WHO HAS PRODUCED
AS IDENTIFICATION.
SIGNATURE F NOTARY TYPE OR PRINT NA E OF NOTARY
NOTARY PUBLIC TITLE
COMMISSION NUMBER (SEAL)
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