HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-I553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
On- 0 1 ay- goo -a M.0 flMo lh
(Parcel Idtt/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 Cod, I shall be responsible for assuring
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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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Proper Owner Name (Please Print) 3 `�
1 LP
\0Pciey vwrteraPgnature Date �'-'�V 'J
STATE OF FLORIDA, COUNTY OF S+ I (a C I 'e
ACKNOWLEDGED BEFORE ME THIS _( 9 DAYOF IJ o rrh
BY 8 j \I 0n `^ 0 `^ rn LwHO IS PERSONALLY KNOWN TO ME (� OR WHO HAS
PRODUCED
AS 1IDENTIFICATION,
SS NA N r UBLIC TYPE ` OUR K PRINN \ n� vONNJ OH
T NOTARY
GGOg118ei1 COMMISSION NUMBER
(SEAL)
•,•"perof//'•.,, RICHARD DOUGIAS JOHNSON
Notary Public-Sule of Florida
SLCPDSD Revised 04/11 /2011 Comm;ssior # GG 0848t1
•:' My Comm.Erpires Mar 20, I021
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