HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building fir, Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel id#/L.egal 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.
—j`c5se,0CLIaon
Property Owner Nam (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF 5+ L ijcj
ACKNOWLEDGED BEFORE ME THIS DAY OF I ® "l A .20 g-Z.,
BY WHO IS PERSONALLY KNOWN TO ME ([:]) OR WHO HAS
PRODUCED AS IDENTIFICATION.
4;A&"Q" &A, 1-,
SIG ATURE OF NOTARY -PT LIC TYPE OR PRINT NOTARY y
COMMISSION NUMBER
(SEAL)
=1b R BURFORD
llA-State of Floridalofl #HH 218910SLCPDSD Revised 04/11/2011 �1l�esioil �xplreaary 08, 2010