HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT ,
COUNTY Building & Code Regulations Division
• R I D A 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#/Le'gal escriptio Address)
for which I:have applied to St. Lucie County for a Final Develop nt Permit. In
accepting this Final Development Permit, BP Number as '1 I acknowledge
that as owner of the above described property, and in accor e 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 OWner Name(PI int) —�
C
Property O Date
STATE OF FLORIDA,COUNTY OF '� ��
ACKNOWLEDGED BEFORE ME THIS ,�p�.,DAY OF�P� 20
MQ
BY V( rRft>�WHO IS P��NALLY KNOWN TO ME�OR WHO HAS
PRODUCED L Q li L\` AS IDENTIFICATION.
SIGNATURE
/'y�''7� Y PUBLIC TYPE OR PRINT NOTARY
(`>(-Q-�l�tiJ�c-iMMISSION NUMBER
(SEAL)
ELLEN VAUGHN
?2° eS State of Florida-Notary Public
SLCPDSD Revised 04/11/2011 Commission # GG 270079
% FOFF�oP My Commission Expires
6etdUff 92 �022
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