HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34952-5652
(772) 462- 155_
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property, %016 ficm FAV
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RECEIVED for which I have applied to St. Lucie County for a Final Development Permit. In
Z�2� 'accepting this Final Development Permit. BP Number , I acknowledge
14 N that as owner of the above described property, and in accordance with Section
)armittint3 Department 7.04.01(D), St. Lucie County Land Development Code, 1 shall be responsible for assuring
-F G.uele County 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.
Property Owner Name (Please Print)
Property Owner Signature Date
STATE OF Fi4�, COUNTY OF Ma rj-,rnb
ACKNOWLEDGED BEFORE METHIS 1(Y DAN' OF
WHO IS PERSONALLY KNOWN TO ME (1—:5 OR WHO HAS
PRODUCED LN/ AS IDENTIFICATION.
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1 NATUREOF AR�Q \J TYPI OR T NOTARti' —
N ]A COMMISSION NUMBER
My Comm si lon Expires
December 26, 2021
SLCPDSD Reviscd 04111/2011