HomeMy WebLinkAbout Filled Land Affidavit f
PLANNING & 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 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.
C AM biJGt 7 A' )-U I/4-1
Property Owner Name(Please Print)
Pr erty Owner Signature Date
STATE OF FLORIDA,COUNTY OF ,))
ACKNOWLEDGED BEFORE ME THIS O2q DAY OF ��/`� vvV r` 20 l
BY " `'e fCC-1(V WHO IS PERSONALLY KNOWN TO ME LEI)OR WHO HAS
PRODUCED AS IDENTIFICATION.
(,\y33 cu CGfe ► l
T OF NOTARY PUBLIC TYPE OR PRINT NOTARY
CT COMMISSION NUMBER r
JALYSSA CARDELL
c, *,COMMISSION#HH 1717 .
EXPIRES:MAY 19,2024
�^� Bonded through lst state insurance
SLCPDSD Revised04/1l/2011 �J���•
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