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 W/Legal description/Address)
for which I have applied to St. Lucie County for a Final Develo ment Permit. In
accepting this Final Development Permit, BP Number Z to?,_0 07 ]: 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 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.
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Property Owner me (Please Print)
Pro er �/
P tY ignature Dal
STATE OF FLORIDA. COUNTY OF-5L.—
ACKNOWLEDGED BEFORE ME THIS ZZ __ DAY OF ScUlo�,r';
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BY citan —
—`a WHO IS PERSONALLY KNOWN TO ME (X ) OR WHO HASPRODUCED / r C
`AS IDENTIFICATION
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AR ARUBLIC �IL�AQ� Ql�i JU^N JOh/
TYPE OR PRINT NOTARY
GGOgygal COMMISSION NUMBER
(SEAL)
1�µr'o A• RICHARD DOUGLAS JOHNSON
SLCPDSDRevised 04/ll/2011
i1.�r Notary Public - Slale of Florida
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n®�l Comm-ssior.AGG084821
��°:' M Comm. Ea ires Mar 20.2021
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Bonded hough Nabonal Nolary Assn.