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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 +�3 I, the undersigned, am the owner of the following described property, I- 1911)- 0*.07- DoD� idN/Legal description/Address) ru c I for which I have applied to St. Lucie County for a Final Development Permit. In accepting this Final Development Permit, BP Number . L , 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. an QdctmS Proper Owner Name (Please Print) 2-II-20 rMperry � lgnature Date STATE OF FLORIDA. COUNTY OF S 1 I U ( %.t ACKNOWLEDGED BEFORE ME THIS 14 DAY OF F4 b/ 20 a,O BY e)ry q r\ Q CI cl r" S WHO IS PERSONALLY KNOWNTO ME' V ' i n FOR WHO HAS PRODUCED NUMBER SLCPDSD Revised 04/11/2011 AS IDENTIFICATION. lJUYQI43 VOwNsom TYPE OR PRINT NQ 16 (SEAL) ••'p��n'j".,, RIOMDOUGUd JOHNSON Ii; :4:e_ Notary Public -Stale ofFlaica ODruassonp00084821 yF�+Ea",r• My Cemm.Esp!res M920,2021 •....,.... 8UNa0dft0NaUJNaay0.un