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 undersigned, am the owner of the following described property,
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(Parcel ld#/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.
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Property Owner Nam�(�Pll e Print)
Pro er Owner Signature Date
STATE OF FLORIDA, COUNTY OF S� A -AA LA.--
ACKNOWLEDGED BEFORE ME THIS '2-0 -lr� DAY OF , 20 21
BY Pls PERSONALLY KNOWN TO ME LO) OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE NOTARY PUBLIC TYPE OR PRINT NOTARY
6c(� COMMISSION NUMBER Notary Public State Of Florida
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MY O� jpn GG 345514
Expires 06/1612023
SLCPDSD Revised 04/110011