HomeMy WebLinkAboutFILLED LAND AFFIDAVIT:PLANNING & DEVELOPMENT SERVICES DEPARTMENT .
Building'&:Code Regulations Division
2300 VIRGINIA AVENUE
. FORT PIERCE, FL 34982-5652 .
(M) 4624553
SCABY
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FILLED. LAND AFFIDAVIT
I; the undersigned, am the owner of the following described -property,
3%loZ C10� - o t g Z. crca _
6 L�s--°7yn. �fi 8 t h Atv-c4 rr :- • PA co P4_2 3
(Parcel.Id#/Legal description/Address)
for which I. 'have applied to St. Lucie. County. for _.a Final .Development Permit. In
accepting this ='Fiiial 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.
Property Owner Name (Please :Print)
Property Owner Signature Date.
loi�STATE OF FLORIDA, COUNTY OF•
ACKN 'LEDGEQBEF MET S : DAY OF _ 20
BY/��[ �i 1� �� WHO IS PERSO A LYkO�ELL) OR WHO HAS