HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division RECEIVED
2300 VaGINIA AVENUE
FORT PIERCE, FL 34982-5652 A U G 3 12021
(772)462-1553
St. Lucie County
Permitting
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel 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 , 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.
F o �-fty A 44 dv"S'�'
Property Owner Name (Please Print)
P e O �erSinature Date
STATE OF FLORIDA, COUNTY OF
ACKN/O�WLE,D�G/EEDD BEFORE METHIS �� DAY OF _��A 20�_,
BY L9"C i'dFA I A --B^A,4b(r )C4( ]WHO IS PERSONALLY KNOWN TO ME (0) OR WHO HAS
PRODUCED
SIGNATURE OF NOTARY PITMC TYPE O
IMISSION NUMBER
SLCPDSD Revised04/11/2011
AS IDENTIFICATION.
Sgt�apt�,EppLLcNlii
VAU
(- "�Inission Notary p bl
MV Oc derss' n E22oes9