HomeMy WebLinkAboutFilled Land Affidavit -- -- :�� PLANNING & DEVELOPMENT SERVICES DEPARTMENT
- Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
Nps
FILLED LAND AFFIDAVIT RECEIi,`=D o8 2916
I,the undersigned, am the owner of the following described property,
(Parcel Id# egal description/Address)-
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number ( 2--0NO 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.
Property Owner Name(Please Print)
Property Owner Signat re Date
STATE OF FLORIDA,COUNTY OF &�I-�L.[�U,C
AC OWLEDGED BEFORE ME THISi_,DAY OF L`� � 20
BY MPA WHO Is PERSONALLY KNOWN TO ME(—)OR WHO HAS
PROD ED ASI ENTIFICATION.
SIGMAfmf
OF NOTARY PUBLIC TYPE R PRINT NOTARY
COMMISSION NUMBER
(SEAL)
90E CI HUGHES
*; MY COMMISSION#FF 950090
SLCPDSD Revised 04/11/2011 EXPIRES:January 12,2020
Rt;I Bonded Thru Notary public Underwrilers