HomeMy WebLinkAboutFilled Land Affidavit�1
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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,
9-600 WA- 6—DN0AlE'
(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.
Prope O r Name(Please Print)
2l�/��
Property Owner §'li5iature Date
STATE OF FLORIDA, COUNTY OF��
ACKNOWLEDGED BEFORE ME THIS Q DAY OFU��/ 20
BYbq 16 Q>e t ( WHO IS PERSONALLY KNOWN TO ME ()6 OR WHO HAS
NUMBER
AS IDENTIFICATION.
TYPE O PRINT NOTARY
(SEAL)
State of Florida
SLCPDSD Revised 04/11/2011%on
RE
FF 914312
12019