HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE "�' �� fa"
FORT PIERCE, FL 34982-5652 RE C E- 11 �° L:m
(772)462-1553
OCT 17 -9016
FILLED LAND AFFIDAVIT PERMITTING
St. Lucie County, FL
I, the undersigned, am the owner of the following described property,
45° NW Pc�hCC�FFc�y�,�.�,
(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 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 Owner Name (Please rint)
o-ml ss
Property Owner Signature
STATE OF FLORIDA, COUNTY OF,
ACKNOWLEDGED 0 I
BY �
PRODUCED
SIGNATURE OF NOTARY "19C
SLCPDSD Revised 04/11/2011
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Date
,
DAY OF �f Vr , 20
WHO IS PERSONALLY KNOWN TO ME ( OR WHO HAS
AS IDENTIFICATION.
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