HomeMy WebLinkAboutFilled Land AffidavitPLANNING & 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,
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(Parcel Id#/Legal c
for which I have applied to St. Cucie 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 (Pleas Print)
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�Property`Owner Signature ate
STATE OF FLORIDA, COUNTY OFSA= 1-�c VG
ACKNOWLEDGED BEFORE ME THIS _ DAY OF A.0fl� �� 120
BY ` WHO IS PERSONALLY KNOWN TO ME (D OR WHO HAS
PRODUCED vU AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC
COMMISSION NUMBER
TYPE Olk PRINT NOTARY
(SEAL)
\'OVY'l o HEATHER '! }RD
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SLCPDSDRevised04/11/2011'� Commission # GG 'It 117
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