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
Ste, Car !D�
(Parcel Id#/Legal dewription/Address) o
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'develop''ment 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.
Prkerty er Name(Please Print)
Property er Signature Date
I
STATE OF FLORIDA,COUNTY OF
ACKN WLEDGED BEFORE ME THIS DAY OF 20l
BYV� 1 tIS PERSONALLY KNOWN TO MEL_)OR WHO HAS
PRODUCED D2- AS IDENTIFICATION.
SIGNATUJOFOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
E !I;
ANQtLA M HUFF
�lP lieli�i
Notary Public-State of Florida
Commission#FF 234730
SLCPDSD Revised 04/11/2011 , ' My ,omm.Expires May 27.2019
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