HomeMy WebLinkAboutFilled Land Affidavit1
COUNnT
FL O R
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & iCODE REGULATIONS DIVISION
1 2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
I
FILLED LANDS AFFIDAVIT
i
i
I, the undersigned, am the owner of the following described property,
(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 ingranting 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.
��%L-vq N\cq,%\.s ,
Property Owner Name (Please Print)
i
operty Owner Signature Date
STATE OF FLORIDA, COUNTY OF 2� kllZ.1 C
A OWLEDGED BEFORE ME THIS � DAY OF V 20 ,
BY L I r v 1��1U l� WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED
NOTARY PUBLIC
COMMISSION NUMBER
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
(SEAL)
MARIAH MILLS
'•E r Commission # FF 023763
Expires June 3, 2017
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SLCPDSD Revised 08/24/2010