HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
IWO 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 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.
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perty Owner Name (Please Print) j
C. c-(/ -
'roperty caner Signature Date
STATE OF FLORIDA, COUNTY OF O
ACKNOWLEDGED BEFORE ME "rHls _Lk DAY OF bk CY/11qkI , 20_ 3,k,
BY A-kkLj-L-A- WI-10 IS PERSONALLY KNOWN TO ME (a) OR WI10 HAS
PRODUCED, AS IDIiNTIF'ICATION.
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SIGNATI OF
NOTARY PUBI I ' TYPE Olt PRINT NOT Rl
0 0!"1 COMMISS NUMBER Cassidy Berger
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NOTARY PUBLIC
STATE OF FLORIDA
Comm# GG973629
�HCE IS Expires 3126/2024
SLCPDSD Revised 04/11/201 1