HomeMy WebLinkAboutFilled Lands AffidavitI ,, _I
PLANNING & DEVELOPMENT SERVICES DEPARTIYIENT
o , --
Building & Code Regulations Division
• 2300 VIRG'INIA AVV4UE
FORT PIERCE, FL 34992-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel IM/Legal desViption/Address)
for which I have applied to St. Lucie County for .a Final Development Permit. Ir.
accepting this Final Development Permit, BP Number , I acknowledg(
that as owner of the above described property, and in accordance with Sectiol
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assurinE
adequate drainage so that the immediate community WELL 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.
3-a� zl
Dale
STATE OF FLORMA, COUNTY OF 6-r(ter
ACKNOWL DGED EFORE ME THIS � DAY OF Hcx/c , 20 2 ,
BY P�"'
i WHO IS PERSONALLY KNOWN TO ME C[a OR WHO HAS
PR0DC3CED1�4�' t�. / c �C�� i ( S�„ AS IDENTWICATION.
SIGNATURE OF NOTARY PUBLIC
(4 12-SO 1 COAMssiox NUMBER
SLCPDSD Revised 04/11/2011
TYPE OR PRINT NOTARY
(SEAL)
2-ch -PI
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