HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
Q 2340 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
(Pa" I 1
R & k 1
Id#1LegaPffescrJl0on1ddddres�s)
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.
Property Owner Name(Please Print)
& Kmc - I
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF
- L
ACKNOWLEDGEDBEFORE MEaawH(
DAY OF 20
BY 1 1 IS PERSO LY KNOWN TO ME{_�OR WHO HAS
P ODUCED AS IDENTIFICATION.
IGNAT �
URE O OTARY PUBLIC 4APE OR fRINT 1316TARY
COMMISSION NUMBER
(SEAL)
ANGELA M HUFF
Notary Public-State of Florida
SLCPDSD Revised 04/11/2011 = Commission#FF 234730
Expires;May 27,201'-
My Comm.Exp
„`+ Bonded through National Notary Assn.