HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
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,
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(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
acknowledge
that as owner of the above described property, and in accordancelwith 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 Coutlty 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.
Y an -damS
Property Owner Name (Please Print)
Property ignature
Date
STATE OF FLORIDA, COUNTY OF. S N LAC I Q
ACKNOWLEDGED EIEFORE ME THIS (� DAY OF t4 C)"J a T, bs r
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BYW _ pry aye WHO IS PERSONALLY KNOWN TO ME C K) OR WHO HAS
PRODUCED
l `AS IDENTIFICATION.
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TYPE OR PRINT NOTARY
"0848a) COMMISSION NUMBER
(SEAL)
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RICHAP,ODOUGLASJOHNSON
Nolary Public - Sia1e of Florida
S LC PDS •.
Comm'ssior.#GG084821
D Rev ised 04111/2011 _ 11�/1\l .•:
My Comm. Expires Mar 20.2021
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