HomeMy WebLinkAboutFilled Land Affidavit PLANNING& DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
COLINTY At
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#/Legal description/Address). v
f6r 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 isneither 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 ame(Please Print)
Pro O i afore Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF ��/�! 20 2z—,
BY WHO IS PERSONALLY KNOWN TO ME LE OR WHO HAS
PRODUCED H/ v AS IDENTIFICATION.
As/
SIGNATURE OF NOTARY LIC TYP9 OR PRINT NOTARY
COMMISSION NUMBER.
(SEAL)
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