HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE _
FORT PIERCE, FL34982-5652 RECEIVED j
(772) 462-1553
NOV 3 2021
FILLED LAND AFFIDAVIT ST. ;l<uvie 0ounty Pennittirr, �
I, the undersigned, am the owner of the following described property,
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AC 51 # C,
(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.
n _
Property Owner Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF
BY
PRODUCED
[elm
SLCPDSD Revised 04/11/2011
DAY OF _V • .20�'
b WHO IS PERSONALLY KNOWN TO ME 0 OR WHO HAS
TYPE OR PRINT NOTARY
COMMISSION N
KAREN S. NIELSEN
4-1v;State of Florida -Notary Publi AL)
Commission # GG 2074P4c My Commission Expires
1 " June 12, 2022
AS IDENTIFICATION.