HomeMy WebLinkAboutFilled Land Affidavit SEA��-.t _ 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,
(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.
Property Owner Name(Please Print)
Property Owner Sign Date
STATE OF FLORIDA,COUNTY OF 1 U
ACK WLEDGED BEFO E THIS 4 .DAY OF A 20
Vii` < 8[T' (;-' hd 9 NALLY KNO ME( OR WHO HAS
PRODUCED Lam- A AS IDENTIFICATION.
SIGNATURE OF ARY PUBLIC OR PRINT NOTARY
COMMISSION NUMBER
t^I" )
ANGEL- M HU
:. • ;�? Notary public A FF
Commissio State of Florida
vioP`O` My Ca n�'FF 2387
30
SLCPDSD Revised 04/11/2011 ", Bonded h ouExFires May 27,2019
9hNationa►Not Assn.