HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
SCANNED
BY
1, the undersigned, am the owner of the following desc; . ribed property, St. Lucie courlty
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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 flirther 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.
Properyy 9wner Name (Please P,rint)
Date
STATE OF FLORIDA, COUNTY 04.
ACKNOWLEDGED BEFORE NIE THIS DAY OF 2J
BYdVBV;,Q &A!��14�Q!WHOISPE 0 LY KNOWN TO NE L nF7_�
wN OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIGNATURE OFNCfARY PUBrIC V U TYPE OR PRINT NOTARX
CONNISSION NUNIBER
(SEAL)
SLCPDSD Revised 04/11/2011
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