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,
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(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 15 G1 -o 131. , 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 OjyAer Signature Date
STATE OF FLORIDA,COUNTY OF S;- �Gie—
ACKNOWL�E"DGED BEFORE ME THIS es\ DAY OF C 20
BYSQ c rC\t Lj �"�Q Y� WHO IS PERSONALLY KNOWN TO ME L—)OR WHO HAS
PRODUCED L L AS IDENTIFICATION.
" � �� dnv..� G�Vkns
SIGNATURE OF NO Y PUBLIC TYPE OR PRINT NOTARY
5A1 r- .COMMISSION NUMBER
;PµrPoaSEAL)DEANNA GIVENS
Notary Public-State of Florida .'
» •=My Comm.Expires Dec 16,2016
^* ` Commission#EE 858761
Banded Through National Notary Assn
SLCPDSD Revised 04/11/2011