HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, ;7,0
owner of the following described property,
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(Parcel d#/Legal des iption/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.
Property"
ropertyer N e (pie Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF 4— 120 17,
,
BY t� + r� J WHO IS PERSON KNOWN TO ME L�) OR WHO HAS
i
PRODUCED
SIGNATURE OF IQOTARY PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
4 _VC)
OR PRINT NOTARY
(SEAL)
FL.2_
AUDREY B, HUMPHREY
MY COMMISSION # FF 174772
EXPIRES: March 6,2019
nded Thru Notary Public Underwriter,
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