HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building &c Code Regulations Division
2300 VIRGD41A AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
-100 05L]- 000- U 5397 1V
(Parcel Idf#/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 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.
bNaylt-dams
Property Owner Name (Please Print)
Property ignature O D
Date
STATE OF FLORIDA. COUNTY OF S r I Ik C I d
ACKNOWLEDGED BEFORE ME THIS 31 DAY OF rr W9 "5 t 20 Z c?
BY r eA hS j4 ct ck M WHO IS PERSONALLY KNOWN TO ME (_Xj OR WHO HAS
PRODUCED
AS IDENTIFICATION
SNATUREOFN rAR UBLIC IG.NAQ� q Ju�N� OH
TYPE OR PRINT NOTARY
G6-089ea1 COMMISSION NUMBER
(SEAL)
•1�r��'p� A .,
RICHARD DOUGLAS JOHNSON
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SLCPDSD Revised 0011/2011 h�Sl
Notary Public - Stale of Florida
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My Comm. Expires Mar 20.2021
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