HomeMy WebLinkAboutFilled Land Affidavit PLANNING& DEVELOPMENT SERVICES DEPARTMENT
COUNTY
Building& Code'Regulations Division
RECENED 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
SEP 2 7 Z021 (772)462-1553
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FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,.
1423 --5 6
(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.
s �
Property Owner me ase Print)
Property Owner S gnature Date
STATE OF FLORIDA,COUNTY OF
OWLEDGED BEFORE ME THIS l DAY OF ,20 f
B (r WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
dI
RODUCED � N .'G AS IDENTIFICATION.
NATURE OF NOTARY A&LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 LASHAHNAINGRAM-RAIiMING
*: *_ W COMMISSION Il GG 275060
EXPIRES.December 20,2022
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