HomeMy WebLinkAboutFILLED LAND AFFIDAVIT 1-24-18SCANNED
St LucieCOU*
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.O4.O1(1)); 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 Ownerjgnature Date
RID `�STATE OF FLO A, COUNTY OF S_�
ACKNOWLEDGED BEFORE ME� �T(HIS DAY O�F. � 20 LA .
By � �� �1/ SDd lUf 1f�VJfIO IS PERSONALLY KNOWN TC)O ME__L-,1"O HAS
AS IDENTIFICATION.
S GNA OF NOTARY PUBLIC
TYPE OR PWT NOTARY
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(} Z-�3commisSION NUhIBER
(SEAL)
P`B`�
ANNY M. GUZMAN
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Notary Public • State of Florida
SLCPDSD Revised 08/24/2010
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commission # GG 037233
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My Comm. Expires Oct 10, 2020