HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code, Regulations Division
2300 VIRGIIJIA AVENUE
FORT PIERCE, FL 34982-5652 - --
(772) 462.1553 RECEIVE"
FILLED LAND AFFIDAVIT FEB 99 2020
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
h5D5 NQ U VSm A -P Rlycl 1311--100- ol3g- 000-`
(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 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 Name (Please Print)
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Property O.�nel'$ignature
Dale
STATE OF FLORIDA, COUNTY OF —it
ACKNOWLEDGED BEFORE ME THIS 1 J DAY OF _ `-Pi 20 a0
BY 51 LI..YY CY r+t G m S WHO IS PERSONALLY KNOWN TO ME (K OR WHO HAS
PRODUCED1AS IDENTIFICATION.
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G01345-41 COMMISSION NUMBER
SLCPDSD Revised 04111/2011
(SEAL)
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RICHARD DOUGLAS JOHNSON
Notary Public -Stale of FloridaCommission#GG084821My
Comm. Expires Mar 20,2021 Batla1 Rxa*NaW NotaryAm,