HomeMy WebLinkAboutFilled Land Affidavit0
Y PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code. Regulations Division
2300 VIRWNIA AVENUE
r11`� FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,.
L001 HIC1<0yy Dr 3HO0 -UoG-OUP
(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 .�9 , 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 iginature Dat6
STATE OF FLORIDA. COUNTY OF V� C I _
ACKNOWLEDGED BEFORE ME THIS DAY OF Fe h 20 Z C
BY 1jryGn QdQYY1S WHO IS PERSONALLY KNOWN TO ME(XJOR WHO HAS
- l AS IDENTIFICATION.
�tL�.A� �o,g�Aj UhMjav
SIGNATURE Ur TAYVPUBLIC TYPE ORPRINT NO Y
GA2848a) COMMISSION NUMBER
(SEAL)
RICHARD DOUGIAS JOHNSON
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SLCPDSD Revised 04/11201I
Notary Puh6c-Sate of Florida
Commission#GG OB4821
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My Comm. Fultes Mar 20.2021