HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGTNIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel `celld#/Legal description/Address) \Y 3r
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 accordance I with Sectdion
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.
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Property wner Name (Pie tint)
Property ignature
Dat'
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED EIEFORE ME THIS DAY OF 20
BY 1J LJA �� 4 tVHO IS PERSONALLY KNOWN TO
R WHO FIAS
1) O
PRODUCED _
`AS IDENTIFICATION
S NATURE OF N rAR UBLIC y( NJON
TYPE OR PRINT NOTARY\l;
GGos4ea� COMMISSION NINMaFR
SLCPDSD Revised 04/11/2011
(SEAL)
«H�"o' p•.,
°. ` •':
RICHAP,D DOUGLAS JOHN50N
Nrnary Public - Sl:ale of Florida
Commssior. A GG 084021
My Comm Expires Mar 20, 2021
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