HomeMy WebLinkAboutFilled Land AffidavitR E C E I',' D AUG 112017
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & 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#/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 is
to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
S � LG C "�- L
Property weer Name (Pease Print)
r Owner Signature
q:7-17
Date
STATE OF FLORIDA, COUNTY OF '%- . L-U Cj-
ACKN\OWLEDGED BEFOREMETHIS 3 r DAY OF T /20
BY i.fiYa WHO ERSONALLY KNOWN TO ME (&/ ) OR WHO HAS
AS IDENTIFICATION.
A
TYPE OR PRINT NOTARY
bl4ry ISSION NUMBER 1
..�"j 61
p .`i►�Y °�Mv
'�_ 9 WEATHERINGTON
a Notary Public • State of Florida
, My Comm. Expires Aug 20, 2017
'•nUF,:F, dCommission # FF 37018
SLCPDSD Revised 04/11/2011