HomeMy WebLinkAboutFilled Land AffidavitST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
561462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(tax ID/legal description/address)
for which I have applied to St. Lucie County for a Final Development Permit. In accepting
this Final Development Permit, BP Number CW03 - ® 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.
OAVI 0 �j 13aniAW On h('Q j> 9/a c.%a,5
Property Owner Property Owner Date
(Print) (Signature)
STATE OF FLORIDA, COUNTY OF ✓I!V1L�
SWORN TO AND SUBSCRIBED BEFORE ME THIS a6 IT DAY OF
BY C_ &tLt0 O IS PERS� KNOWN TO ME OR WHO HAS PRODUCED
AS IDENTIFICATION.
�a.P_c yc �'► hs�r�, NATALIE RE(seal)
SI NATURE OF NOTARY TYP { I ►W�::
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NOTARY PUBLIC TITLE co miss
SLCCDV FORM NO.: 011-00