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
1 RECEIVED
MAR 3 0 ' 220
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
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(Parcel IdM/Legal description/Address)
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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 wnerSlgnature Date
STATE OF FLORIDA, COUNTY OF L) 3 I U C I X
ACKNOWLEDGED BEFORE ME THIS of O DAY OF 1 b ZD—.d—\Q
BY Rya" UCAWa WHO IS PERSONALLY KNOWN TOME (—jOR WHO HAS
PRODUCED
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GGo8++gat COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
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TYPE OR PRINT NOTARY
(SEAL)
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RICHARD DOUGLAS JOHNSON
Notary Public - Stale of FlcWa
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