HomeMy WebLinkAboutFILLED LAND AFFIDAVITST. LUCIE COUNTY
Ln BUILDING & ZONING
J 2300 VIRGINIA AVENUE
t FORT PIERCE, FL 34982-5652
��pRt�p • 561462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following d
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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 Name Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF
BY
SIGNATURE OF NOTARY
NOTARY PUBLIC TITLE
IS _ DAY OF W , 20�ID�
IS PEF�SQNALLY KNOWN TO ME OR WHO HAS PRODUCED
AS IDENTIFICATION1-6 pn
TYPE OR PRINT NAME OF NOTARY
t'bb_Zj77(_ G� (SEAL)
O MISSION NUMBER
�,ItY'a�r•, LORI A. KARABAICH
MY COMMISSION # DD 217769
a; of EXPIRES: June 1, 2007
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�'' Bonded Th. Notary Puhllo Underwriters