HomeMy WebLinkAboutFilled Land Affidavit r 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,
X16 Z--
(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.
roperty Owner Name-(16asej rint) _
d�Property Owner Si ature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME HIS ✓ DAY OF 20
BY PERSONALLY OWN TO ME U OR WHO HAS
r---PRMVCED AS IDENTIFICATION.
IVL
SIGNATURE OF NOTARY PU11LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
SPRY PUB� 7MILONEENotaghftof FloridaMy Commr 22,2017: Comm775710,EF0'0 Bonded Thotary Assn.
SLCPDSD Revised 04/11/2011