HomeMy WebLinkAboutFilled Land AffidavitI
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
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,
341 0110R R S H^rric RI K3 S10(1FT of Intc 13 R 14 R W 2 2FT nfl nt 1 F 11 R H^rric St Ft Pierce El 34982
(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.
Property O r Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF &4 UA C L,1�
ACKNOWLEDGEDBEFOREME THIS 3 I DAY OF 20 l n
BY Il c 0 VI kA i_ WHO IS PERSONALLY KNOWN QME ( V) OR WHO HAS
PRODUCED AS IDENTIFICATION.
0,600_1 rC' I�i.r)S
siMATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
& V 2,4 i COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 NEE
tate of Florida
isn FF 966029
2020