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
St. Ludo C6gUnty
I, the undersigned, am the owner of the following described property,
Palm City, FL 34990
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number 1605-0116 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 Signature
STATEOF FLORIDA, COUNTY OF �t d
ACKNOWLEDGED BEFORE NIE {THIS an�, DAYOF�,y
BY Sir �. (A\ '±`� WHO IS PERSONALLY KNOWNTO ME(. OR WHO HAS
AS IDENTIFICATION.
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SIGNATUREOF NOTARY PUCK � TYPE OR PRINT NOTARY
CF 143G COMMISSION NUMBER
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My CO OM 124, 4020
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