HomeMy WebLinkAboutFilled Land Affidaviti
PLANNING.& DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGrNA AVENUE
FORT PIERCE, FL 34M-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersign�e_d, �am�the
owner of thefollowingdescribed property,
OW lX l AI� I cCfl n
reel Id#/Legal description/Address)
t I O I" L
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
I acich. owledge
that as owner of 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.
Property Owner. Name (Please Print)
Property ignatur,
Date
STATE OF FLORIDA, COUNTY OF_ t I C 1�
ACKNOWLEDGED REFORE ME THIS \ DAY OF j.%p V
20 ti O
BY W ar3 �0WHO IS PERSONALLY KNOWN TO ME
i� OR WHO FIAS
PRODUCED
STANATURE OF N rAR UBLIC'
"08yB11 COMMISSION NUMBER
SLCPDSD Revised 04/1 1/2011
AS IDENT[FICATION
�IG.�AQ� Qltii �+u�NSON
TYPE OR PRINT NOTARY
(SEAL)
1 µ�'o;',A .,,
RICHARD DOUGLAS JOHNSON
.`�.
LLhh\\l .
Nolary Public - Sine of Florida
Commission. 0 GG 084821
My Comm. Expires Mar 20.2021
Bonded WouyhNAOMINalaryAAssn,