HomeMy WebLinkAboutFilled Lands Affidavit i
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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(Paree Id#/Legal d eription/Address)
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for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number IL C -(SI 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 offmy property which will not adversely affect the immediate
community.
Prope era se Print)
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OFLloll—
ACKNOWLEDGED BEFORE ME THIS DAY OF (n/T 20
BY IWHO IS PERSONALLY KNOWN TO ME C OR WHO HAS
PRODUCED ~C AS IDENTIFICATION.
S NATURE 4 TARY PUB IC E OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
AUDREY B.HUMPHREY
MY COMMISSION#FF 174772
EXPIRES:March 6,2019
qd `' Bonded Thru Notary Public Underwriters