HomeMy WebLinkAboutFilled Land Affidavit_•:;: :.:;,.;;. PLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
SEP 10 ,i%J
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
0 0 - 0 0 % 3 - 000-
(Parcel IdJ#/Legal description/Address)
0 st
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.
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Property Owner Name (Please Print)
Property ignature
Date
STATE OF FLORIDA, COUNTY OF S I U C t, -f
ACKNOWLEDGED BEFORE ME THIS 1 DAY OF +
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El
y
PRODUCED WHO WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
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AS IDENTIFICATION.
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S NATURE OF N fAR UBLIC TYPE OR PRINT 'NOTARY N�OH
GG089gal COMMISSION NUMBER
(SEAL )
RICHARD DOUGLAS JOHNSON
Nolary Public -Scale of Florida
SLCPDSD Revised 04/11/2011 (�)�•
'mi 11101 �•
Comm;ssior.gGG084021
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M Comm. Expires Mar 20.2021
Bonded through Nalional Plolary Assn.