HomeMy WebLinkAboutFILLED LAND AFFIDAVITSCANNED
BY
Sr Lucie County
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
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(Parcel 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.
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Pro caner Name (Ple a Print d/s//
Prope Okner Signature Da
STATE OF FLORIDA, COUNTY OF Sk - 1.Q CIA
ACKNOWLEDGED BEFORE ME THIS I� DAY OF (�tJl�/1 20 i -
BY J UOLYL IV Y--V_S5OVWHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED
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SIGt4AWRE OFJTOTARY PUBLIC
t e a COMMISSION NUMBER
SLCPDSD Revised 08/24/2010
AS IDENTIFICATION.
TYPE OR
T SPY �v Notery Public State at Fbtlda
Julie 981yd
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