HomeMy WebLinkAboutFILLED LAND AFFIDAVIT 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, am the owner of the following described property,
9415 BUNTING LN/1334-502-0057-000-4
(Parcel Id#/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(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)
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Property Owner Signature Dat
STATE OF FLORIDA,COUNTY OF ST LUCIE
ACKNOWLEDGED BEFORE ME THIS 161 DAY OF 20_%
BY T: WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED_DJUVER LICENSE AS IDENTIFICATION.
Luc i_ F::nrn c x c)
SIGNATUR OF PUBLIC TYPE OR PRINT N Y
AAOMMISSION NUMBER
LUCY 8aRCC10 (SEAL)
off.
;`�/,•�� Notary Public-State of Florida
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Commission GG 937274
of n My Comm,Expires Dec a.2023
Bonded Narcla.NCt3ri Ass'.
SLCPDSD Revised 04/11/2011