HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRMU AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553.
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel IM/Legal descnption/Addr &r
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..
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Property OvtmeName (Pleas t)
Pr erty.Owne; Si a ate
STATE OF FLORIDA, COUNTY OF Q •1
ACKNOWLEDGED BEFO THIS DAY OF /"'� 20+
B �% IWH\O LS P ALLY KNOWNTO MB ELOR WHO HAS
1. 'i w . 1 r AS IDENTIFICATION.
PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
OR PRINT NOTARY iv
(SEAL)
s
`osP�Y Pu&4c AUDREY B. HUMPHREY
MY COMMISSION # GG 3008W
EXPIRES: March 6, 2023
bonded Thru Notes 51te Dnd_ e— n---inters ';