HomeMy WebLinkAboutFilled Land AffidavitPLAIVIVING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIAAVENUE
FORS' PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(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
as owner o:f the above. described property, and in accordance with Section
7.04.0.1(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.
Mill am_ brawn Rd (A ms
Property Owner Name (Please Print)
1I�120
Property ignature Date
STATE OF FLORIDA, COUNTY OF St ILt C'l f.
ACKNOWLEDGED BEFORE ME THIS 14 DAY OF Seq t-e—VV%b a tr-
2p
BY Wittig yy% BrMg n I>,OIQ tnnC WHO IS PERSONALLY KNOWN TO ME ( 1( ) OR WHO HAS
PRODUCED
AS IDENTIFICATION
S NATURE OF"A UBLICIG.NAB� JV�NSOH
TYPE OR PRINT NOTARY
"0816911 COMMISSION NUMBER
(SEAL)
•1�µv'o p .,
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SLCPDSD Revised 04/11/2011 lt�l
fi �1�7
RICHARD DOUGLAS JOHNSON
Notary Public -Stale of Florida
Commissior.0GG084821
•;� :`
My Comm. Expires Mar 20. 2021
Bonded through National Nmary Assn.