HomeMy WebLinkAboutFilled Land AffidavitCouN-ry_
F L C FI I D it '
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel fd#/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.
lere� c
roperty Owner Name (Please Print)
Property Owner Signa re Date
STATE OF FLORIPA, COUNTY OF S� �� C-\ Q
I
ACKNOWLEDGED BEFORE ME THIS � DAY OF ��� L 2017L
BY --1ZCVtA' e e �C?�X IS PERSONALLY KNOWN TO OR WHO HAS
I
AS IDENTIFICATION.
"b,91y I D V4 1< DN
TYPE OR PRINT NOTARY
COMMISSION NUMBER
DAVID SIPPER
Commission fDD 995518
€: Expires September 25, 2014
BondedThruTmyFainInmrieW s&7018
SLCPDSD Revised 08/24/2010