HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND 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 Fi al Develo e t Permit. In
accepting this Final Development Permit, BP Number O0le —0 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.
7), 10 -1ri�-
Date
STATE OF FLORIDA, COUNTY OF `_
ACKN EDGED BEFORE ME THIS I C DAY OF 20 �
WHO TS PERSONAL Y K WN TO ME�) OR WHO HAS
PRODUCED AS IDENTIFICATION.
I
IGN TURE OF NOTARY P IC TYPE OR PRINT NOTARY
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, COMMISSION NUMBER
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SLCPDSD Revised 04/11/2011 .t�„r �t,�y "otary Public - state of Florida
* w My Comm. Expires Dec 20, 201 S
Commission # FF 177249
Bonded through Notional Notary Assn.
(SEAL)