HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LANDS AFFIDAVIT
1, the undersigned, am the owner of the following described property,
(Parcel ld#/Legal description/Address)
f%A
CANNED
BY
StlucieCountv
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 CountyLand 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 Narn� (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF &. LOA G;
ACKNOWLEDGED BEFORE ME THIS 2_g-4A DAY OF JV tj i� 20—U-1
BY &-T74 kirAcfa- WHO IS PERSONALLY KNOWN TOME V"ORWHOHAS
PRODUCED
GNA URE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMM
MMISSION NUM13ER
SLCPDSD R�ised 08/24/20 10
AS IDENTIFICATION.
(SEAL)
ENT.SCOTT
MISSION # DD 727904
S: November 17, 2011
Sonded ThnkNowry PuNc Undl�wm