HomeMy WebLinkAboutFilled Land Affidavit Filled out and signed 1.27.2022PLANNING & DEVELOPMENT SERVICES DEPARTMENT
•e yWN Building & Code Regulations Division
2300 VIRGIINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-I553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel I&/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.
Property Owner Name (P se Print)
Property Owner Signature Dafe
NEW
CSC.; _
STATE OF F+4 I , COUNTY OF' N qc ' i'4
ACKNOWLEDGED BEFORE ME THIS - _ DAY OF TAN U Nk�\,. 120 ;JA ,
BY 2� 1O Ai1 lC , fs WHO IS PERSONALLY KNOWN TO ME ) OR WEIR HAS "' •..
PRODUCED AS I;N?TrICATION.-
IGNATUR$ OF NOTARY PUBLIC TYP R PRINT NOT 4 �+
Notary PubGr =
COMMISSION RNow ®
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My C�err�mjs gxplres.'iz01.22
No.2425724
SLCPDSD Revised 04/11/2011