HomeMy WebLinkAboutFilled Land Affidavit _ PLANNING&DEVELOPMENT SERVICES DEPARTAI-ENT-.- ---- -- -- --.. - - _.__.----
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Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner ofthe following describe property, .
L
(Parcel Id#/Lega 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(Please Print)
teraperty Owner Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS cmL DAY OF 20 L G
DY f PERSONALLY KNOWN TO ME C—)OR WHO HAS
PRODUCED AS IDENTIFICATION.
e-ict—g4uT —
SIGNATURE OITOTARY PUBLIC TYPE OR PRINT POTARY
COMMISSION NUMBER
e,•, ANGELA HUFF
.°a Nowy Rub�iQlte of Florida
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Col"ISS6+M-FF234730
MY Comm.Expires May 27 2019
0omfed through man-1. Assn.
SLCPDSD Revised 04/11/2011