HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
�e 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,
(Parcel Idf!/Leeal deer r /eaa
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
acknowledge
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.
Property O vner N] e (Please Print)S
\ LPI IT)I r1 Property glature
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STATE OF FLORIDA. COUNTY OF At t IA P_- 1� ,
ACKNOWLEDGED BEFORE ME THIS 10 DAY OF BY QJ
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WHO IS PERSONALLY KNOWN TO ME (X 1 OR WHO HAS
PRODUCED __
' 1((I���� `AS 'IDENTIFICATION
S NATURE OF N r UBLIC - ZlcL 'AQ� 4 1 'To 1'M jOM
TYPE OR PRINT NOTARY
"-084�611 COMMISSION NUMBER
(SEAL)
Revised 04/11/2011
;• ,p., RICHARD DOUGLAS JOHNSON
�1 r.. Mlary Public - Sole of Round,SLCPDSD
'\� Comm4s:a: 0 GG 084821
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