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,
e A . . � _ .
I description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
that as owner of the above described ro ertCo'�' 1 acknowledge
in accordance witSection
7.04.01(D), St. Lucie County Land Development dealdshall be responsible for assuring
adequate drainage so that the immediate community WILL L 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.
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Property Owner Name (please print) GG
Proper pature
Date
STATE OF FLORIDA. COUNTY OFL &(' 1 D
ACKNOWLEDGED BEFORE ME THIS
DAY OF m Gy
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— —A A M\ WHO IS PERSONALLY KNOWN TO (� PRODUCED OR WHO HAS
A—nr� AS IDENTIFICATION
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COMMISSION NUMBER
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SLCPDSD Revised 04111 /2011
�:0�^�k•. RICHARD DOUGLAS JOHNSON
-,�F•� NotaryPIc-Sine of Flmda
• • Commss�on # GG
004B21
., ,� My Comm. Expires Mal 20, 2021
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