HomeMy WebLinkAboutFilled Land Affidavit I
PLANNING & DEVELOPMENT SERVICES DEPARTMENT I
Building &Code Regulations Division
2304 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
tL0 r U d� 0ati C I
(Parcel Id#(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 QC014- (07.1 , 1 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 i
adequate drainage so that the immediate community WILL NOT be adversely affected. i
I further acknowledge that in granting this permit for the development of this property, i
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 Nvnerr Name(Please Print)
Property ignature Date
STATE OF FLORIDA,COUNTY OF
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,i�Y 1 L- 0� 0
ACKNOWLEDGED BEFORE ME THIS Q DAY OF 20 �
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BY E tib YV { )', h (tis ,}WHO IS PERSONALLY KNOWN TOME�OR WHO F(AS
PRODUCED AS IDENTIFICATION.
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SIUATURE OF N rUBLIC TYPE OR PRINT NOTARY%3
&&084611 COMMISSION NUMBER
(SEAL) 11
"µvn�j RICHAPO DOUGLAS JOHNSON
Nofary Public-State of Florida
` Commissioe#GG 084821
SLCPDSDRevised04llll20!! M Comm.Expires Mar 20,2021
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