HomeMy WebLinkAboutFilled Land Affidavit�' = - <r_ _.-•._;;:: ,. PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIAAVEMA
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
L
I, the undersigned, am the owner of the following described property,
CX5 34 - 6 oo - -7
(Parcel Idtf/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
acknowl
that as owner of the above described property, and in' �cordaOn e I with Sectdge ion
7.04.0l(D), St_ Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community yVIL_ L NOT be adversely affected.
I further acknowledge that m 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,
_ S
PropertyOwner Name (Please Print)
PropertyZZ Z-
ignature Date
STATE OF FLORIDA, COUNTY OF 5_-• L(LUe-
ACKNOWLEDGED BEFORE ME THIS Z
A , DAY OF CUN.0 (L
BY
ct
PRODUCED
S NATpU,RE OF N rAR UBLIC
Gts-o��� COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
WHO IS PERSONALLY KNOWN TO
20_
OR WHO HAS
AS IDENT[FICAT[ON
12���nec� QI� Jo�N jOM
TYPE OR PRINT NUTARYV
(SEAL)
RICHARD DOUGLAS JOHN50N
Nolary Public - Slale of Florida
Commssw p GG 084821
My Comm Expires Mar 20.2021
Bunded mrayh NalionA NOldry Assn.