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,
(Parcel Id#/Legal descriptio fires a301)
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.
Pro= � ame .- ase Print)
ropeyer,,`;gnature� Date
54
STATE OF FLORIDA,COUNTY OF �� �. / /
ACKNOWLEDGED BEFORE ME THIS_ DAY OF, G'v�f/ // 20 ►O
BY n�OOPERSONALLY KNOWN TOW�)OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIGNATURE OF N Y PUBLIC TYP' R PRINT NOTARY
OMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 o$'•, AUDREYB.HUMPHREY
..-ARE MY COMMISSION#FF 174772
EXPIRES:March 6,2019
gF'0."•`' Bonded Thru Notary Public Underwriters