HomeMy WebLinkAboutFilled Land Affidavit_ PLANNING & 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,
-1, 0 17 UA00- 11 R2 I L *)Ma I f o c 9 Y_
(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
I acknowledge
that as owner of -the above described property, and in accordance with Section
7.04.0l(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 norliable to provide for, or maintain in any form,
adequate drainage off my property which will not) adversely affect the immediate
community,
Property 1, er Name (Please Print)
\
ignat7 l 0? 6
ure
Property
Date
STATE OF FLORIDA, COUNTY OFJ I L U C I
ACKNOWLEDGED BEFO1RE ME THIS 1 1 U ` I
BY ��J �� ri- DAY OF _ V Imp 20_Z V
S WHO IS PERSONALLY KNOWN TO ME (Xi OR WHO HAS
PRODUCED
AS IDENTIFICATION
S NATURE OF N rAR UBLICIG.�AQC JU�+N,foN
TYPE OR PRINT No
Gc o8yl3aI COMMISSION NUMBER
(SEAL)
••�nµV rOr�A .,,
RICHAP,D DOUGLAS JOHNSON
Revised 04/II/201I ..n`W
NolaryPublic-SlaleofFloridaSLCPDSD
Comm"sslor.11 GG 084821
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My Comm. Expires Mar 20.2021
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