HomeMy WebLinkAboutFILLED LAND AFFIDAVITY
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PLANNING 8i DEVELOPMENT SERVICES DEPARTMENT
g & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner
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(Parcel Id#/Legal descriptionLA,ftg
the follo
wing described property,
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for which I have applied to St.1 Lucie County for a Final Development Permit. In
accepting this Final Developmelt 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. -
Owner am ase Print)
rly O r Si e I Date
STATE OF FLORIDA, COUNTY OF I ,
I
ACKNOWLEDGED BEFO THIS DAY O 20,
i
BY V WHO IS PE O ALLY KNOWN TO ME (� OR WHO HAS
PRODUCED //�� ' _ e / AS IDENTIFICATION.
PUBLIC TYPE
[SSION NUMBER
SLCPDSD Revised 04/11/2011
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(SEAL)
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AUDREY B. HUMP HR
"COMMISSIDN # FF 174�77 EXPIRES: 2
uI1 "
March 6, 2019
Bonded 7hru Wary
Puhr, Undeiwrhers