HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT. SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-15B
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 Prin
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF�
ACKNOWLEDGED BEFO•�REE ME THIS\�ca DAY OF �� 20��,
WHO IS PERSONALLY KNOWN TO ME ( f/ OR WHO HAS
PRODUCED
SIGNATURE OF NOTARY PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011 .
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
(SEAL),
STELLA M. HUNTER
+ • �g Notary Public - State of.Florida
Commission. 8 FF 180552
My Comm. Expires Jan 23, 2019
��"" 8a�d#wAmhlWonalNotary Assn.