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 SC'9/l/
St CUco
%C 4n
FL
I, the undersigned, am the owner of the following described property,
-d�.7 ''}71
(Parcel
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(1)), 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 O nerr Name (Please Print)
% Owner Signature Dat
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS J DAY OF_�� .20�,
V�- BY �lE f,S ,(\0\ p�� WHO IS PERSONALLY KNOWN TO ME(b ORWHOHAS
PRODUCED
n ,�I/ I J AS IDENTIFICATION.
JSIGNATURE OF NOTARY P LIC .TYPE OR PRINT NOTARY 41
6 a7C)Cn COMMISSION NUMBER
SLCPDSD Revised 04/112011
ELLEN VAUGHN
tState
of Florid - otery Public
M Commlealon M 00 270079
My C0omlaalon Expiroa
Octber 22, 2022
Al