HomeMy WebLinkAboutFILLED LAND AFFIDAVITr
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DMSION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
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(Parcel
SCANNED
BY
St. Lucie County
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number ISoi . DSSS , 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 (Please Print)
Property Owner Sigdature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE NM THIS nw DAY OF ��rl"LLLY 20
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BYV-' WHO IS PERSONALLY KNOWN TO ME^
��y�// ORWHOBAS
I� PRODUCED
SIGrNA OF NOTARY PUBLIC
Ft i5�-1� COMMISSIONNUNMER
AS IDENTIFICATION.
SLCPDSD Revised 08/24/2010 r - *;