HomeMy WebLinkAboutFILLED LAND AFFIDAVITM
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,
x
(Parcel Id#/Legaldescription/ ddress)
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 Nam—eUntase Print)
Vie, lS 17
Pro71111wner Si ure Date
STATE OF FLORIDA, COUNTY OF '
ACKNOWLEDGED BEFORE ME THIS DAY OF DC�1rLY/ 1 .20�,
BY�(%YLVL 4"I(� WHO IS PERSONALLY KNOWN TO ME (El OR WHO HAS
PRODUCED 7 -
ah ,
I ATUP4EOFNOTqy PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 04/11 /2011
i( C`. AS IDENTIFICATION.
�e
T E OR PRINT NOTARY
j4E j,IARIE CLAUDE JEAN BAPME
o + 4F Notary Public, State of Florida
Commission# GG 41551 ,
My comm. expires Oct. 24, 2020