HomeMy WebLinkAboutFIELD LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
• R 1 0 A 2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
I+ (772)462-1553
FILLED LAND AFFIDAVIT cis �Ln
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I, the undersigned, am the owner of the. following described property,
(Parcel Id#/Legal description/ dres
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.
Property4mer Name ( ase )
bperty04er Signature Date
STATE OF FLORIDA, COUNTY OF cS)r. I—UcAC
ACKN�OWLEDGED BEFORE ME THIS DAY OF 20 LS .
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BY Q!9jeM1e P- GQ Gz. WHO IS PERSONALLY KNOWN TO ME (Nb OR WHO HAS
PRODUCED AS IDENTIFICATION.
L�i�DJg S. FeEnuct+
I NATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
Notary Public State of Florida
(SEAL) .t Linda S French
NoMy Commission GG 120210
f Expires07/o4/2021
SLCPDSD Revised 04/11/2011