HomeMy WebLinkAboutFilled Land Affidavit - - PLANNING&DEVELOPMENT SERVICES DEPARTMENT
o 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,
(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.
ole-f-0' e-
Property er Name(Pleaserint
S �5'
Property Owner SignatW Dat
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF 120-1J
BYh! i�'HO IS PERSONALLY KNOWN TO ME t__j OR WHO HAS
PRODUCED 1cl•`>S �t' o at- O AS IDENTIFICATION.
ly\-)4-
SIGNATURE OF NOTARY P11§BLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
LASHAHNA-INGRAM
Notary Public-State o1 Florida
•e My Comm.Expires Dec 20,2018
Commission#FF 177249
SLCPDSD Revised 04/11/2011 "'F`J'�, Bonded through NationalNotary Assn.
i f oQ;
�.II�I11.�