HomeMy WebLinkAboutFilled Lands Affidavitw:- 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 Id#/Legal d :ription/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 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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rroperuy Owner Name (Please Print)
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STATE OF FLORIDA. COUNTY OF ,S r �G
ACKNOWLEDGED BEFORE ME THIS '-' ___ DAY OF � �
RSONALLY KNOWN T E R WH i
BY
' OR WHO HASPRODUCED _
\AS IDENTIFICATION
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TYPE OR PRINT NOTARYV
"0846at COMNISSION NUMBER
(SEAL)
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RICHARD DOUGLAS JOHNSON
SLCPDSD Revised 04/11/2011 L��••
Notary Public - Slale of Florida
Comrn,ssior.9GG084821
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My Comm. Expires Mar 20.2021
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