HomeMy WebLinkAboutFilled Land Affidavit I 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,
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(Parcel Id#/Legal description/rplressa
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.O1(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 Owner Name(Please Pr t)
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PropertyOwner Sigriitfire J, Date
STATE OF FLORIDA,COUNTY OF_Afi�k
VI�iW
ACKNOWLEDGED BEFORE ME THIS_�DAY OF 20
BYLd&' WHO IS PERS N TIN TO ME(�OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIG-NATURE OF N ARY PUBLIC TY OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
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MY COMMISSION#FF 174772
SLCPDSD Revised 04/11/2011 '' t` EXPIRES;March 6,2019
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