HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 RECEIVED
(772)462-1553
MAY 11 2021
FILLED LAND AFFIDAVIT Permitting Department
St. Lucie County
I,the undersigned, am the owner of the following described property,
(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.
Pr a Owner Name(Please Print)
G
perty Owner Signature Efate
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS _DAY OF' �• * ,20a�
BY�IS:tl "�"\5 WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED ` AS IDENTIFICATION.
SIGNATURE OFF N ARY PUBLIC TYPE OR PRINT NOTARY
%445-w\COMMISSION NUMBER vL;°u DEANNA GIVENS
?4r• �� Notary Public-State of Florida
�A Comm�s�W.H 086359
.,oFrti°o-' My Comm.
Jan 28,2025
Bonded through National Notary Assn.
SLCPDSD Revised 04/11/2011