HomeMy WebLinkAboutFilled Land Affidavit i
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PLANNING&DEVELOPMENT,SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA_AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
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I,the undersigned, am the owner of the following described property,
36N tint q coo t 000 11�—
(Parcel Id#/Legal descilip6on/Address)
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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
1 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.
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Property er Name(Ple Prin
Property r'Signature Dated {{
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STATE OF FLORIDA,COUNTY OP U 3
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ACKNOWLEDGED BEFORE ME THIS DAY OF :V L 7i�
IS PERSONALLY KNOWN TOME OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIG1V E OF NOTARY PUBLIC TYPE OR P N TARY
COMMISSION NUMBER
.yn Notary Public State of Florida
Angela A Caroussos
My Commission GG 19846t1
oRti Expires 03/20/2022
SLCPDSD Revised 04/11/2011
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