HomeMy WebLinkAboutFilled Land Affidavit i 9
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PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division I
2300 VIRGINIA AVENUE.
FORT PIERCE,FL 34982-5652
(772)462-1553
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FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described 1property,
(Parcel Id#/Legal description/Address) lln C h 'lz
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number i- I , 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 sliall 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.
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Property weer Name(Please Print)
Proper Owner Signature Date
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STATE OF FLORIDA,COUNTY OF
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ACKNOWLEDGED BEFORE ME THIS DAY OF I,20_n_,
BY O `�eHC IS PERSONALLY KN WN TO ME� )PR WHO HAS
PRO UCED L AS IDENTIFICATION.
A. I
W"n
S GNAT F N ARY PUB IC TYPE OR PRINT NOTARY
COMMISSION NUMBER {
(SEAL)
SLCPDSD Revised 04/11/2011 Not dry Public State of Florida
I IRMA J. MAYNARD
MY COMMISSION#I FF113673
EXPIRES:April 16.2018
®bnd0d through Western Surety Company