HomeMy WebLinkAboutFilled Land Affidavit4 _ PLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
JUN 19 262p
1,,�the
�undersigned, am the owner of the following described prope T Lucie County, permitting
GW..iLy�__D014- 000 - 1 53 3 S i n
(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
ge
that as owner of the above described property, and in accordance lwith 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.
PProyperty Owner Name (please Print)
—�
Property tgn ature
Date
STATE OF FLORIDA. COUNTY OF -A 1�p
ACKNOWLEDGED BEFORE ME THIS to DAY OF
PR [y_ODUCEDDllam. /i .. ._. WHO IS PERSONALLY KNOWN TO ME tXC 1OR WH-OOFAS
PR—IJ—_—�1
r� AS 'IDENTIFICATION
S NATURE r UBLIC gsL�A2� al Jo�+Nl
TYPEAR PRINT NOTARY
GGo8413a1 COMMISSION NUMBER
(SEAL)
RICHARO DOUGLAS JOHNSON
�1�F•'. Notary Public - Stale of Florida
SLCPDSD Revised 04/11/2011 1 Comm�ssior,pGG 084821
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My Comm. Expires Mar 20. 2021
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