HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
(CANNED
BY FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(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
7.04.01(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 Y r1Q 1 CsP� R l V' $L r
ACKNOWLEDGED BEFORE ME THIS 2
po DAY OF 20 LU
BY �L�CI. l'C (AjA ('�i(:� WHO IS PERSON O WN TO ME(EZOR WHO IiAS
PRODUCED
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SIGNATURE OF NOTARY PUBLIC
G f- f 33 21ColvnvtlsSlON NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
SAW:
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