HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVEXt9�ENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
RECEP. rU AIN 312616
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
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for which I have applied to St. Lucie County for a Final Development Permit. I 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 a immediate
community. a/
Property Owner Name lease Print)
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Property Owner Signature
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STATE OF FL913IM, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF
BY
PRODUCED
OF NOTARY PUBLIC
NUMBER
SLCPDSD Revised 04/11/2011
PATRICEA. Mc
Notary Public
COMMONWEALTH OF MMA,
My Commission Ex!
January 22, 2112
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20
ALL KNOWN TO ME (—_) OR WHO HAS
AS IDENTIFICATION.
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TYPE OR PRINT NOTARY
PATRICE A. MOCCIA
Notary Public
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IMONW HUSETTS
11 My Commission Expires
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January 22.2021
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