HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGR UA AVENUE
FORT PIERCE, Fl, 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
SCANNED
BY
St. Lucie County
I, the undersigned, am the owner of the following described property,
(Parcelld#/Legal
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.
Property Owner Name ( lease Print)
Property�r-Signature Date
STATE OF FLORIDA, COUNTY OF 411n4 &ei ♦v /�/7 �'1'',�,�-/
ACKNOWLEDGED BEgFO�RE' �ME TH/I�S_,(� 1 DAY OF [�d�L .20�
BY �lJIIAm pil4g7 /�j(1(t,I/1S WHO IS PERSONALLY KNOWNTO�ME( 1OR WHO HAS
PRODUCED �} AS IDENTIFICATION.
o ffic, Am C7r1,n
NATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
'� ��GGMMI33IDN NUMBER
PATR4MIANN GRIFFIN
.'
- MY COMMISSION # GG137624
'M+i•�;;� EXPIRES September 26, 2021
SLCPDSD R"iud 04/112011