HomeMy WebLinkAboutFilled Land Affidavit®� PLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
23 DO VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462.1553
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FILLED LAND AFFIDAVIT o 2?, ,�`�V1" F
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1, the undersigned, am the owner of the following described property,
131-L71LD _0iog RDA 21�I CII rIto 'e cam_
(Parcel (d#/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
ge
that as owner of the above described property, and in accordancelwith 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.
H-d fA h)j
Property Owner Name (please Print)
Property tcr'Slgn alum
Date
STATE OF FLORIDA, COUNTY OF lJ 7 U( I .f
ACKNNOOWtIL�E�D('G�EjD� BEFOjREE MME� THIS �I DAY OF _�J � ��) 20 (A 0
BY Cj ) I)-�l`-- t" WHO IS PERSONALLY KNOWN TO ME —J (� 1 OR WHO HAS
PRODUCED
AS 'IDENTIFICATION
S NATUREOF'N r UBLIC `�IL�AE� n� a �iVvnN jON
TYPE OR PRINT NOTARY
Gs�g4P,a1 COMMISSION NUMBER
(SEAL)
�jy.:'o.....
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RICHARD DOUGLAS 1DHNSON
Hilary Pashc-Sole of Florida
SLCPDSD Revised 04/II/201I ))
Comm3sor.# GG 084821
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My Comm.EapieesMar20.2021
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