HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMEN
BUILDING & CODE REGULATIONS DIVISION SEP 12 2019
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 r• Lucie County, Permittin
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FILLED LANDS AFFIDAVIT SCANNED
BY
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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 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.
Prop rty Owner Name (Please Print)
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Prbperty Owner Siga-tuir6 Date
STATE OF FLORIDA, COUNTY OS-1 el4eo )
ACK"WLEDGED BEFORE ME TIHIS e PP--� DAYOF ,20 L �,
i 1S PERSONALLY KNOWN TO ME_ OR WHO HAS
AS (IDENTIFICATION.
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TYPE OR PRINT NOTARY
COMMISSION NUMBER
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