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,
(Parcel
for which I have applied to St. Lucie County foI a Final Development PeiTnit, 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 shallbe 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,
5t. 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.
Property Owner Name lease Print))
Proper ner a Date�
r
STATE OF FLORIDA, COUNTY �uGt
ACK1N,OWLHDOED BEFORE NH THIS �_
BY ("1 LL�h Offi 'I� WHO IS PERSONALLY KNOWN TO ME CD OR WHO HAS
eJC� O COMMISSION NUMBER
SLCPDSD Revised 04/1 IYLOt l
AS IDBNTIFICATION,.
(SEAL)
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