HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
-P 2300 VIRGI IA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
1311-100- blb1-oob--
(Parcel id#/Legal description/Address)
II
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.
Mt
Proper Owner Name (Please Print)
\oNcrty vatu" Date a o
Date
STATE OF FLORIDA, COUNTY OF & WLI D
ACKNOWLEDGED(]EIE,F�O`RE ME THIS 013 DAY OF 1 1 {,J r t 20 a.(�
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BY _a\y � CL WHO IS PERSONALLY KNOWN TO ME ( X—j OR WHO HAS
PRODUCED
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S NATUREOFN r UBLIC TYPEOR PRMsN l(UKPR1N 2 JV^N�OM
T NOTARY
6Go84i3dt COMMISSION NUMBER
(SEAL)
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RICHARD DOUGLAS JOHNSON
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SLCPDSD Revised 04111/2011
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