HomeMy WebLinkAboutFilled Land AffidavitPLANNING & 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
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(Parcel Id#/Legal description/Address)
property,
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for
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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 , 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 Owner TUarne (Please PH t)
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Property Owner iknature Date
STATE OF FLORIDA, COUNTY OF ` b—A
AC OWLEDGED BEFORE ME THIS DAY O 20
BY WHO IS PERSONALLY KNOWN TO ME C__) OR WHO HAS
PRODUCED Z_ AS IDENTIFICATION.
SIGNATURE OF OTARY PUBLIC TYPE OR PRINT NOT Y
COMMISSION NUMBER
ANGELA M HUF®
Notary Public • Stata of Florida
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SLCPDSD Revised 04/11/2011 Commission # FF 234730
Commission
Comm- Expires May 27, 2019
Bonded through National Nota A§§n.