HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICESDEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described
description/Address)
SCANNED
BY
St. Lucie County
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.
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Property 0 er Name (Please Print)
1L ;
perty O igna Date
STATE OF FLORIDA, COUNTY O� ' `
ACKNOWLEDGED BEFORE METHIS_ DAY OF
ME _ OR WHO HAS
V AS IDENTIFICATION.
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SIGNATURE OF NOTANY PUHLIC
COMMISSION NUMBER
V 3y` ANGELAM.HUFF
+; MYCOMA7SSION ✓e EE 083530
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Lary Pu61io Underv+nters
SLCPDSD Revised 08242010