HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 V RGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 4624553
FILLED LAND AFFIDAVIT
I, the undersigned am the owner of the following described property,
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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
?.04.t)1(D)3 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,
SL 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)
Property Owne Signature Date
STATEOF FLORmA, COUNCY OF v� LGLC-.y ACKN/OWLEDGED BEFORE METHIS J
DAY OF af :- 20
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BY 161 A HO IS PERSONALLY K OWN TO ME ([a OR WHO HAS
PRODUCED
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M I: . R..
SLCPDSD Reviud 09/t 120I l
TYPE OR PRINT NOTARY
(SEAL)
AS IDENTIFICATION,is