HomeMy WebLinkAboutFILLED LAND AFFIDAVITr
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34! 82-56.52
(772) 462-1553
FILLED LAND AFFIDAVIT SqNNEp
St 4OCfeCounty
I, the undersigned, am the owner of the following described property,
(ParcelIdk/Legal
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number l�I acknowledge
that as owner of the above described property, and m 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)
PropOry OWer Signature Date
STATE OF FLORIDA, COUNTY OF
Fq
ACKNOWLEDGED BEFORE ME THIS �� DAY OF f .20 IqTT BY (KKR WHO IS PERSONALLY KNOWN TO ME Q) OR WHO HAS
PRODUCED
�iyCIl\TN I �
SIGNATURE OF NOTAR1I UBLIC TYPE OR T NOTAR
Y COMMISSION NUMBER
SLCPDSD Revised 04/112011
(SEAL)
AS IDENTIFICATION.