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,
1%940 0J -two R)i%PAK i or 7 ft 70 Ir l
(Parcel IM 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 fiirtber acknowledge that in granting this pemit-for t�hn-de;'elopment-ef 93is pr-er,..
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.
jPropewner N e ease Print)
r Signature a e
STATE OF FLORIDA,COUNTY OF '` XtR_.
ACKNOWLEDGED BEFORE ME THIS DAY
BY"t C `v�W� TA WHO IS PERSONALLY KNOWN TO ME L_)OR WHO HAS
ODUCID-' 1c�tl�� `7 LQ Q'J AS IDENTIFICATION.
CNSIATURE OF NOTARY PUB TYPE OR PRINT NOTAR
COMMISSION NUMBER
LASMAJ1 r
Iq da
•-My Comm.Expire ec !?11TH C()PY
Commission#FF 177249 -..
SLCPDSD Revised 04/11/2011 %°t �' Bonded through National Notary Assn.