HomeMy WebLinkAboutFILLED LAND AFFIDAVIT 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,
(Pareef 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..
OrNcL
Property Owner Name-(Please Print) f
operty Owner Signature` Date
STATE OF FLORIDA,COUNTY OF^
ACKNOWLEDGED BEFORE ME THIS oZB DAY OF: 20 7
BY Rt Cad,�g D GUI46-ig J,C.WHO IS PERSONALL KNOWN TO ME(_j OR WHO HAS
PRODUCED (J ft l V CAS CamI C'ews AS IDENTIFICATION.
!Jo 4 D-rV4`� /`tN N Yc�R'SIGerI
SIGNATURE OF I@TARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL).
DOLRE
BASKIN
MY COGG 030145' .SLCPDSD Revised 04/11/2011 % , 4ee EXPIr 2,2020Bonded Thc Underwriters