HomeMy WebLinkAboutFILLED LAND AFFIDAVITa PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
id 2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
SCANNE-0 (772) 462-1553
BY � JAN
St Lucie CountY 0 4 2018
FILLED LAND AFFIDAVIT
By........................
I, the undersigned, am the owner of the following described property,
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(Parcel Id#/Legal description/Address)
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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 O � r Name (Please Print)
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Prop Owner Signature Date
STATE OF FLORIDA, COUNTY OF LUC ( G
ACKNOWLEDGED BEFORE ME THIS DAY OF L/� C �^'� 6 T 20 I
BY Pe ��� '� C� ` L /� � � WHO IS PERSONALLY KNOWN TO ME � I OR WHO HAS
PRODUCED
AS IDENTIFICATION.
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SIGNATUF&OF NOTARY PU4IC TYPE OR PRINT NOTARY
FE 13 L 3 5COMMISSION NUMBER
(SEAL)
`,.. SUZANNE J GOUDREAU
f vY 1• i MY COMMISSION #FF136325
SLCPDSD Revised 04/11/2011 :,'ew ,.;oPA` EXPIRES June 25, 2018
,407r 390.0153 FioridallotaryService.com