HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
COUNTY
Building&Code Regulations Division
• R I D 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 !210Q�Q, 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 P tint
er Dat
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF .20
BY !::� A,j C0C re (((/// O IS PERSONALLY KNOWN TOME!0 OR WHO HAS
7FI _PRODUCED 0 AS IDENTIFICATION.
�r
SIGNATURE
JTURE OF NOTARY P IC TYPE OR PRINT NOTARY
560 " 0 COMMISSION NUMBER
=o<Pp�pp,, ELLEN VAUGHN
_State of Florida-Notary Public
-• +_
9r oPc Commission # GG 270079
My Commission
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SLCPDSD Revised04/11/2011 22' 2022