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,
(Parcel td#/Legal de cription/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
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 COLlrlty 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.
f 04A _AdOLOIU
Property Mner Name (Please Print)
Property ignature I .Z6- Z
Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED EIEFORE ME THIS -_ DAY OF ct-VLLL-& r J '
20-KA
BY r Ctm WHO IS PERSONALLY KNOWN TO ME
fOR WHO FfAS
PRODUCED
— 1� `AS IDENTEFICATION
tNATURE OF N rAR UBLIC �1C.�Ak� J
` Q�hj u�.NJ ON
TYPE OR PRINT NOTARY
GGo8yg�t COMMISSION NUMBER
(SEAL)
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RICHARD DOUGLAS JOHNSON
SLCPDSD Revised 04/11/2011 ��•� '
Notary Public - Suie of Florida
Com-nssior.0GG084821
My Comm. Expires Mar 20.2021
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