HomeMy WebLinkAboutFILLED LAND AFFIDAVIT0
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,
(31, �II- 06 91 0,6_Or
description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting *this Final Development Permit, BP Number f- 1' - W 60, 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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Pr perty Owner Name ease Print)
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operty Owner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS 1 DAY OF
BY 1 ,'t VI ^j-a F-tb I \I G W hPIJ`{ RHO IS PERSON KNOWN T ME(ElOR WHO HAS
AS IDENTIFICATION.
SLCPDSD Revised 04/11/2011
(SEAL)
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AUDREY B. HUF89HREY
MY COMMISSION ik FF 174772
EXPIRES; March G, 2019
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