HomeMy WebLinkAboutFILLED LAND AFFIDAVITSCANft
BY
ST LUCIE COUNTY
ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGEgA AVENUE
FORT PIERCE, FL 34982-5652
772-462-1553
FILLED LANDS AFFIDAVIT
•••
for which I have applied to St. Lucie Countyfor 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 7.04M (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
01'_
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS 1 U DAY OF 200
BZE. I 14 WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
AS IDENTIFICATION.
SIGNATURE OF NOTARY
NOTARY PUBLIC 'TITLE
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TYPE OR PRINT NAME OF NOTARY
COMNIISSION NUM BEP
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