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
RECEIV7D JUL 16 2015
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.
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Property OkGer Name(Please Print)
7 t7&
opedy Owner Signature Date
STATE OF FLORIDA,COUNTY OF . U3lam\P
ACKNOWLEDGED BEFORE ME\\THIS
\ DAY OF 12
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BY�"-AN8, tr)1� WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED L AS IDENTIFICATION.
SSIIGNATURE OF N ARY PUBLIC TYPE OR PRINT NOTARY
G1�� 1q 1 COMMISSION NUMBER
DEANNA GIVENS
P�Bi''� Public-State of Florida
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:• " Notary
:M Dec Comm.Expires Dec 16,2016
=.s,• "o` Commission#EE 858761
SLCPDSD Revised 04/11/2011 E�F F�°� Banded Through National Notary Assn:
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