HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
772 462 I553
( ) RECEIVED
SCANNED FILLED LAND AFFIDAVIT
BY OCT 15 'n;g
St. Lucie Countv
ST. WCla County, Permlcelng
I, the undersigned, am the owner of the following described property,
for which I hav"pphed 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.
erty Owner me (Please Print) -
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Property Owner Signature Date
STATE OF FLORID& COUNTY OF d� YSC'F�
ACKNOWLEDGED BBE�ih �., FORE METHIS /'3� DAYOF ,y.20�
BYT/Af,4 Cl, WHO IS PERSONALLY KNOWN TO ME( -�iOR WHO HAS
PRODUCED
GNATURE OF NOTARY PUBLIC
COMMISSION NUMBER
SLCPDSD Reviwd 04/1 I201I
AS IDENTIFICATION.
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TYPE OR PRINT NOTARY
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