HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
SCANNED
FILLED LAND AFFIDAVIT BY
St. Lucie County
I, the undersigned, am the owner of the following described property,
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for which I have applied to St. Lucie County for a Final Develo m t Permit. In
accepting this Final Development Permit, BP Number _�a oy-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 fiuther 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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�'nperty Owner Name (Please Prin )
(wProperty Owner Signature I Date
STATE OF FLORIDA, COUNTY OF .a D . w`^y—
ACKNOWLED\G'ED BEFORE ME THIS DAY OF I L , 20I 1 .
BY I 1`^VLF WHO IS PERSONALLY KNOWN TO MEVrIn OR WHO HAS
PRO CE (/� //jj �� 'IDENTIFICATION.
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SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMB
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Commle6lon # GG 007074.
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SLCPDSD Revised 04/I1/2011