HomeMy WebLinkAboutFilled Land Affidavit I
I
PLANNING&DEVELOPMENT SERVICES DEPARTMENT
BUILDING&CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)46271553
FILLED LANDS AFFIDAVIT
I,the undersigned, am the owner of the following described property,
(Parcel IdkXe4a1 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)
E•[Ce� ya to �ti � _ 1
Property Owner SignatdrJ Date
STATE OF FLORIDA,COUNTY OF S}L V t
SWORN TO (OR AFFIRMED) AND SU13SCRIBED -,-FORE ME OF PHYSICAL PRESENCE OR
ONLINE NOTORIZATION THIS _ DAY OF f 20 a)
NAME OF PERSON MAKING STATEMENT
PERSONALLY KNOWN �( OR PRODUCED IDENTIFICATION
TYPE OF IDENTIFICATION PRODUCED
SIGNATURE OF MTARY PUBLIC TYPE O
DEANNA GIVEsS
N , COMMISSION NUMBER '?: ` Notary Public•state,7'r.orica
+ ed,' Commissior
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SLCPDSD Revised 4/24/2020