HomeMy WebLinkAboutFILLED LAND AFFIDAVITBY
St Lucie County
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE _
FORT PIERCE, FL 34982-5652 I RE(772)462-1553
FILLED LAND AFFIDAVIT JAN 2 6 2018
:NEI� E!�Ii1 Y: permitting
I, the undersigned, am the owner of the following described property,
Id#/Legal description/.
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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Property Owner Name (Please Print)
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Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF 10 C> I #4 -1 �) ✓ GL^
ACKNOWLEDGED BEFORE ME�THIS
� ,��1' DAY OF rA t V �j .20 JI ,
BY C L� �� lYi 1 i� WHO IS PERSONALLY KNOWN TO ME C`176x WHO HAS
�fi a o e 9 COMMISSION NUMBER
SLCPDSD Revised 04/11/201 I
AS IDENTIFICATION.
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