HomeMy WebLinkAboutFilled land aff PLANNING & DEVELOPMENT SERVICES DEPARTMENT
COUNTY 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,
(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.
Property Owner Name(Please Print) RzCEIVEp
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Property Owner Suture Date Pe itt,. D
t.
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STATE OF FLORIDA,COUNTY OF C-�
ACKNOWLEDGED BEFORE ME THIS /L3 DAY OF 20 �� ,
BY .WHO IS PERSONALL KNOWN TO ME(0 OR WHO HAS
PRODUCED AS IDENTIFICATION.
�&A& . -4- A��A ,,a �<
siONXTURE O TARY PUB TYPE 0RPRNT NOTARY ,&—
COMMISSION NUMBER
(SEAL)
t
HEATHER BURFORD
o4PBY PVB�: state of Florida-Notary Public
SLCPDSD Revised 04/1112011 _e ma's
_* +_ Commission #GG 183217 5
My Commission Expires
February 06, 2022
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