HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE /� /� p�p� CC
FORT PIERCE, FL 34982-5652 �bf'llWitl6®
(772) 462-1553 SCANNED
BY
FILLED LAND AFFIDAVIT St.. Lucie County
I, the undersigned, am the owner of the following described property,
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.
_O> . � ow
ProperCy weer Slgna une— Date
STATE OF FLORIDA, COUNTY O
ACKNOWLEDGED BEFORE ME THIS / DAY OF 20
BY ` WHO IS PERSONALLY KNOWN TOME C OR WHO HAS
PRO CED AS IDENTIFICATIIO'N..ID
I
17�
SI NATURE OF N Y PUBLIC TY R PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/112011
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