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 description/4,ddress)
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.
,ART InVQ ( t,
Property OwnerT e(Please Print)
Pr ty Owner Signa Date
STATE OF FLORIDA,COUNT Y OF 2)0—cLr—
ACKN01i'LEDGED BEFORE ME THIS / lod DAY OF 20
BY �'f/Z WHO IS PERSONALLY KNOWN TO ME�OR WHO HAS
PRODUCED ` -�Dk ��e 41?-0- D�D ~O AS IDENTIFICATION.
i
SIGNATUR F OTARY PUBLIC TYPE OR PRINT NOTARY
CO,NWISSION NUMBER
EWS
(SE COrtlliliSSion##AR FF 9-08392
Expires May 6,2020
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SLCPDSD Revised 04111/23011