HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 SCANNED
(772)462-1553
e County
FILLED LAND AFFIDAVIT St. Luc
I, the undersigned, am the owner of the following described property,
D - Uce)(01 - (.
description/Address)
for which I have applied to St. Lucie County for a F' al Development Permit. In
accepting this Final Development Permit, BP Number i bC) I - QIQ1I acknowledge
that as owner of the above described property, and inaccordan a 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)
Prop rty Owner Signature
Date
STATE OF FLORIDA, COUNTY OF vHtL
ACKNOWLEDGED BEFORE ME TIES DAY OF -L ,
20
BY ` 1 U Il O WHO IS PERSONALLY KNOWN TO ME L) OR WHO HAS
P Ol UCED (1 LJO I'S I� AS IDENTIFICATION.
SLCPDSD Reviud 04/11/2011