HomeMy WebLinkAboutFILLED LAND AFFIDAVITY
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGNIA AVENUE
FORT PIERCE,FL34982-5652 SCANNED
(772)462-1553 BY
St. Lucie County
FILL-ED LAND AFFIDAVIT
1, the undersigned, am the owner of the following described property,
(Parcelldg/Legal. description/Address) 11 N!„�^I� �i Pi-6 /Z� f4 '
for which I have applied to St. Lucie County for a Final Development Permit. In t�
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 fiurther 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 er 1Qame (Please Print)
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XProperty Owner Signature Date
STATE OF FLORIDA, COUNTY OF4, �_ _(_L �Q_ / L�
ACKNOWLEDGED HEFO Iv1E PHIS DAY OF ,20 1
BY�._._.�WHO IS PERSONALLY K OWN TO ME (_) OR WHO HAS
�___AS IDENTIFICATION.
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TYPE- OR PRINITNOTAr.Y
NUMBER
(SEAL)
Notary Public Stale of Florida
,��� Francene Newman
SLCPDSD Revised 04/11/2011 My Commission GG 221434
�qp� Expires 05/2312022