HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVEL.OPMENT SERVICES DEPARTMENT
® Building & Code Regulations Division
- -- - 2300 VIRGINtA AVENUE 6 -' (' '
FORT PIERCE, FL 34982-5652 a ,,� A
(772)462-1553
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FILLED LAND AFFIDAVIT ='sr:i c-ri;ac
}. LLcic FL
I, the undersigned, am the owner of the following described property,
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areel Id#/Legal descriodoin/Address)
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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.
Prvperty 0Eyner Name (Please Print) -
ArO�O�ieri�Iature b `�Q ^ t
Date
STATE OF FLORIDA, COUNTY OF $�r�116
ACKNOWLEDGED BEFORE ME THIS DAY OF
BY 207,
WHO IS PERSONALLY KNOWN TO ME C___) OR WHO HAS
i1
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OF
AKY PUBLIC
NUMBER
AS IDENTIFICATION.
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TYPE OR PRINT NOTARY
(SEAL)
µi:SSs JAMESROUAN
SLCPDSD Revised 04/11/201 l � •• ° = MY COMMISSION A GG 008627
, a•` EXPIRES: November 4,2020
q Bonded Thru Notary Public Underwriters
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