HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGR41A 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,
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.
Am,
Property Owner Name (Please Print)
Property Owne Signature D I e + `
STATE OF FLORIDA, COUNTY OF .i�—_ LU ,( f..X.c
ACKNOWLEDGED BEFORE MMEE,THIS
n LA DAY OF .lJ , 20 L
BY W71 wh. Sf C�IJ^ AfV HO IS PERSONALLY KNOWN TO ME CEb OR WHO HAS
PRODUCED ��,/D L �' ` ry AS IDENTIFICATION.
SIGNATURE OF NOTAR P LIC TYPE OJUA NOTARY CL
a_;)7COMMISSION NUMBER
E
=zow'wf,, ELLEN VAUGHN
s, State of Florida -Notary Public
COr MISSI0n N GG 270079
SLCPDSD Revised 04/112011 %.',',+ol �, �' My COMMISSlon Expires
__ 0ctober22,_2022