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
I, the undersigned, am the owner of the following described property,
131 I_ LU_ 00 13 - 000l 1 )1 a ml ra n o rrvl
(Parcel IdM/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 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.
BY I aV1 SIG WS
Property Owner Name (Please Print) /�
rroperty UWrter-Signature �I q 0 a E)
Date
STATE OF FLORIDA, COUNTY OF& 1 I 14 ( ( A
ACKNOWLEDGED BEFORE ME THIS1919
/� (A` DAY OF � CI \_� 20 -a o.
BY rah f7 a1V1 5 WHO IS PERSONALLY KNOWN TO ME C—k) OR WHO HAS
PRODUCED
AS IDENTIFICATION.
SS NATUREOFN r UBLIC
TYPE OR PRMT NOTARYV
GGOSIlba) COMMISSION NUMBER
(SEAL)
RICHARD DOUGLAS JOHNSON
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