HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERV][CES 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,
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Id#/L,egal description/Address;)
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for which I have applied to St.. Lucie County for is Final Developmenit Permit. In
accepting tl•1is Final Developmert Permit, BP Number , I acknowledge
that as owner of the above (iescribed property, ;and in accordance with Section
7.04.01(D), St. Lucie County Lanid Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community NWLL NOT be adversely affected.
I further aclnowledge 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 Ownier Name (Please Print)
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J?�)erty Owner Signature Date,
STATE OF FLOII:IDA, COUNTY OF S� ` kuka
ACKNOWLEDGED BEFORE ME'I'II1S t9 DAY OF � — 20
BY wc&u" �WI10 IS PERSONAL NOWN O ME (_) OR W1-10 11AS
PRODUCED AS IDEN111FICATION.
SIGNATURE OF NOTARY PUBLIC 'rYPE OR PRINT NOTARY
COMMISSION NUMBER
SLCPDSD Revised 04/11/20 11
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* * MY =I10N # GG 071108
Pr EXPIRES: February 25, 2021
tier PO Raved 1 hru Budget Nolary Services