HomeMy WebLinkAboutFilled Land AffidavitI
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
ode Regulations
Building & 0 V RG N A AVENUE Division
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFF IDAVIT
1, the undersigned, am the owner of the following described property,
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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. �� 1C," -� sl acknowledge
that as owner of the above described, property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code,1 shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
1 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.'
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Property Owner Name (Please Print)
Property Owner Signature hate u
STATIi OFFLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS__. DAY OF ��! ,20
BY JIhV \ 1 P ` k—W',L—ot � WHO IS PERSONALLY KNONVIN TO ME (YOR WFiO HAS
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—STG-,TArUI2 E OF NOT tY PUBLIC.
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SLCPDSD Revised 04/11P01 I
AS IDENTIFICATION.
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