HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
' 2300 VIRGIMA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT {� y
OCl
ST. Lucie County, Permitting:
I, the undersigned,, am the owner of the following described property,
1 111 wI 4 Y U YI D 'Av ,f
(Parcel Ida/Legal description/Address)
IDD, DDLN- DDO-I
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 accordance I with Section
7.04.0I(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.
an ftawyls
Property Owner ame (Please Print)
Property ignature — MI I U l LID
Date
STATE OF FLORIDA, COUNTY OF S �- t 1,l (, I �
ACKNOWLEDGED BEFORE ME THIS H DAY OF 0C_ t'
20 2 D
By
' k) f-`/'^((A WHO IS PERSONALLY KNOWN TO ME ILLJ �� yy �
OR WHO HAS
PRODUCED
AS 1_NJ MDENTIFICATION
QV sNATURE OF N rAR UBLIC tk1^TYPE OR PRINT NOTARY
GG o8ygal COMMISSION NUMBER
(SEAL)
RICHARD DOUGLAS JOHNSON
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SLCPDSD Revised 04/11/2011
Nolary Public -Scale of Florida
Comm;ssior.#GG084821
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My Comm. Expires Mar 20.2021
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