HomeMy WebLinkAboutFilled Land Affidavit®_ ! PLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
-, 2300 VIRCiVIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-I553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
5-3ki� Soh �o d�pfim ►3I► '101 oo�t
(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 , 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.
hnlun a rn f
irroperry Owner Name (please Print)
Property v igriat Dal D
STATE OF FLORIDA, COUNTY OF s k I Id C t .
ACKNOWLEDGED BEFORE ME THIS DAY OF _ V W\-k
�x, � �� 20 a�
BY UJL.1i1-@.Y� �A JIIA WHO IS PERSONALLY KNOWN TO ME A v (Xy OR WHO HAS
PRODUCED
AS
t(�� `AS IDENTIFICATION
Ri;C 1 k1 � QI �1fV^Nj M
S NATURE OFN fAR UBLIC TYPE UR PRINT NOTARY
GGo846al COMMISSION NUMBER
(SEAL)
�: .e••;
RICHARD DOUGLAS JOHNSON
Wary PU311e-SNIe of Amida
•
SLCPDS D Revised 04/ 11 /2011
I
Comm�ssmn A GO 084821
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My Comm. Expires Mar 20. 2021
awed bwP N3140 NoUry Aim.