HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 V02GINIAAVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
RECEIVED
FEB 14 ?070
aT, l wp, Monty, Permitting
I, the undersigned, am the owner of the following described property,
05 -To np10 pr. 3`JDL UIn- 01-19- 000-)
(Parcel Idlt/Legal description/Address)
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.O1(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.
r (A n aacm,
PropertyOwner Name (Please Print)
erty ign afore all I3I X0
Date
STATE OF FLORIDA, COUNTY OF S � 1 u C 1 -1
ACKNOWLEDGED BEFORE ME THIS_I DAY OF F•F..iJ 20 a-O
BY—�—� �yY a, tyj S WHO IS PERSONALLY KNOWN TO ME L X I OR WHO HAS
P-L AS IDENTIFICATION.
SIGNATURE OF NO Y LIC `t`'"' �uot�Ad J U�NJtnr
TYPE OR PRINT NOrARy
&kC> 46a► COMMISSION NUMBER
(SEAL)
;, ••a;:i',;k.,
RICHARD DOUGLASJOHNSON
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SLCPDSD Revised 04/11/2011 '���g_F
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WW ryPu6iic-Slate of Florida
Commission # GG 084821
My Comm. Expires 61ar 20.2021
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