HomeMy WebLinkAboutFilled Land Affidavit PLANNING &DEVELOPMENT SERVICES DEPARTMENT
1 Building&Code Regulations Division
2300 VIRGINIAAVENUE
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 descri 'on/Aad»,-ss
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.
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Property G<vner Name(Please Print)
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Property 04her Signature Ddte
STATE OF FLORIDA,COUNTY OF
A'A
ACKNOWLEDGED BEFORE ME THIS �' DAY OF 201_& '
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BY A WHO IS PERS A LY KNOWN TO ME(_)OR WHO HAS
PRO C AS IDENTIFICATION.
SIGNATURE OF N VRY
PUBLIC %1��nkTYgR7PN�OTAP���
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
; `Pik•, AUDREYB.HUMPHREY
MY COMMISSION#FF 174772
^: EXPIRES:March 6,2019
Bonded Thru Notary Public Underwriters