HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT .
Building & Code Regulations Division
• • 2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
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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.
Property Owner Name (Please Print
Property Owner Signature
o /`'(
Date,
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS 1 DAY OF A U G osS — .20 C> ,
BY , WHO IS PERSONALLY KNOWN TO CEI) OR . S
PRODUCED 71111,
I 1 AS IDENTIFICATION.
SIGNATURE OF TARY PUBLIC TYPE OR PRINT NOTARY
i COMMISSION NUMBER
«„
COMMISSION # FF 2222M
EXPIRES: April 20, 2019
Bonded Thiu Not" Pubtie Unden+dtara
Revised 04/11/2011