HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGINIAAVENUE
FORT PIERCE, FL 34982-5652 1
(M) 462-1553
FILLED LAND AFFIDAVIT
I
l
I, the undersigned, am the owner of the following described property,
MI-1 Do- 00 us- 000- 0 53t-1L1 I U
(Parcel [d#/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 accordance I 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.
i
W. 5Y-N Cl ti' RaGM S '
Property Own r Name (Please Print)
I
Perty gat — I —II�^
ure Date' I
STATE OF FLORIDA. COUNTY OF %b , \ M c C
ACKNOWLEDGED BEFORE ME THIS li DAY OF
202-0
BY tw • r �—�� ��amS WHO IS PERSONALLY KNOWN TO ME '( I OR WHO HAS
PRODUCED
AS IDENTIFICATION
«�Aec� Job
S NATURE OF i
AR UBLIC N30N
TYPE OR PRINT NOTARY
GG-OBye�I COMMISSION NUMBER V
(SEAL) I
•� s �'p;;A•.,,
RICHARD DOUGLAS JOHNSON
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SLCPDSD Revised 04/11/2011 nW\ . •:
Notary Public - Stale of Florida
Commssior,pGGOB4fJ21
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My Comm. Expires Mar 20, 2021
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Bunded bong j National Nolary Assn,