HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the tnd9fsigked, am the owner of the following described property,
for which I `hive 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.
41'1eAVA
Property Owner 1fAme j(Please Print)
Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS l kv �cDAY OF 20 ,
BY � P �j�� ,W O S PERSO LY KNOWN TO ME OR WHO HAS
PRODUCED r, m I 3/ _ ( _ AS IDENTIFICATION.
SIGN URE OF NOT Y PUBLIC T OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
j AUDREYB.HUMPHREY
N' ,= MY COMMISSION # GG 300817
SLCPDSD Revised 04/11/2011 % ,�' `•?;oe EXPIRES: March 6, 2023
Bonded
ix., lhru NO Public Undcrwriters