HomeMy WebLinkAboutMERRITT FILLED LAND AFFIDAVIDPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 V02GMA AVENUE
FORT PIERCE, FL 34982-5652
(772) 4624553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
2 �r 2�✓E2
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
^.04.01(1);, St. Lucie County Land Development Code, I shall be responsible for assurincr
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.
Proper er Name ase Print) � —
P operty Owner Signature Date
STATE OF FLORLDA,COUNTY OF -� � • GG�
ACKNfOiWLEDGED BEFORE ME THIS !� DAY OF /VD✓• 2p�•
%6EFZ �qHO IS PERSONALLY KNOWN To ME(0) OR WHO HAS
PRODUCED ,,CC AS IDENTIFICATION.
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TYPEOR PRlNr NOTARY
COMMISSION NUMBER
SLCPDSD Reviud 04/1120(!
(SEAL)
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