HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINUAVENU�
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
RECEIVED
DEC 17 ?Q19
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
Id#/Legal
for which I have applied to St. Lucie County for la 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 fo the development of this property,
St. Lucie County is neither obliged nor liable to pro ide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community. ,
�Jt 11 i am fi-lnn Adams
Property Owner Name ( lease Print)
—2perty ignature Date
tt
STATE OF FLORIDA, COUNTY OF Jl T UCI 1p
ACKNOWLEDGED
BYtu;IliOhl
(SEAL)
SLCPDSD Revised 04/112011
20-0--
OR WHO HAS
MON.
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-, 652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
I- 100- 0 105 - 000
Id#/Legal description/Address)
for which I have applied to St. Lucie County fora Final Development Permit. In
accepting this Final Development Permit, BP Number _1911- 03 5D , 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. I
('Cryan 06CAMI
Property Owner Name (Please Print)
\ i pIZQ
Property w[[er�signature Dale
STATE OF FLORIDA, COUNTY OFUa 10 t I L4 ( I f
ACKNOWLEDGED BEFORE ME THIS S DAY OF _ Jan bt a ry 20 10
BY 13 ry u n Udolms WHO IS PERSONALLY KNOWN TO ME ( Xj OR WHO HAS
PRODUCED
AS IDENTIFICATION.
AJ
SIGNATURE OF OT X PUBLIC TYPE OR PRINT NOI YY , OVM.bn
(i1GA40 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
(SEAL)
uQ; ��,
RICHARD DOUGLAS JOHNSON
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MyCamm.Espiren Mar20,2021
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