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,
Bay) Li z �'c 4 `PZ V1 3A RR 1
(Parcel Id#/Legal descrip 'on/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(1)), 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.
Prop r Owner N`ante(Pl�sy/Print
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF_3�
ACXNOWkEDGED BEFORE ME THIS DAY OF 20]_G
i
BY 011 LWHO IS PERSON Y KNOWN TO ME��OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OFQJITARY PUBLIC TYPE O RINT OTARY
COMMISSION NUMBER
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o ANGELA A4 H
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f' �o,. M C mission#FF 234730
SLCFDSD Revised 04/11/2011 ofKy
Y omm,Expires May 27,2019
FL
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