HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
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(Parcel Id#/Legal description/Address)
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.
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Property QAer Name(Please Print)
20
Propertyfrier ignature ate
STATE OF FLORIDA,COUNTY OF LUCK
ACKNOWLEDGED BEFORE ME THIS v DAY OF C 20 l
BY %V" f+(AZ2 1 I I WHO IS PERSONALLY KNOYN TO ME C—)OR WHO HAS
PRODUCED AS IDENTIFICATION.
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8IGNATUREP3NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
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KEIE
Cort;?11S6t n#EE 198428
Expires September 15,2016
Borded Thru Troy Fain Insurance 800-385-7019
SLCPDSD Revised 04/11/2011