HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE; FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
undersigned, am t1W owner of the following described property,
IM/Legal description/A`ddr ss!
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.
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STATE OF FLORIDA, COUNTY OF %` )%J 4
ACKNOWLEDGED BEFORE ME THIS rC_ (.k DAY OF IVY Y 120
BY WHO IS PERSONALLY KNOWN TO ME ❑C ) OR WHO HAS
PRODUCED AS IDENTIFICATION.
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COMMISSION NUMBER
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SLCPDSDRevised04/I1/2011 BUIL2415
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LASHAHNA INGRAM 2000050999392
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• Notary PublicmyComm.Expires Dec 20,2018.ae Commissions oval Notary Assn.
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