HomeMy WebLinkAboutFilled Land Affidavit=j;: w:.= PLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGIMA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
reel [d#/Legal de ription/Address)
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for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
acknowledge
that as owner of the above described property, and in accordance I w th 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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Property O��SuName (Please Print)
Proerty ignature Z
Date
STATE OF FLORIDA, COUNTY OF S �( c.
1
ACKNOWLEDGED BEFORE ME THIS _�__ �r�q DAY OF 20 2(
BY A.N•� _S—WHO IS PERSONALLY KNOWN TO ME
PRODUCED OR WHO HAS
AS IDENTIFICATION
SS NATURE F N r AR UBL[C
G6-0$46911 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
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TYPE OR PRINT NOTARY\j
(SEAL)
RICHARD DOUGLAS JOHNSON
• .
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Nolary Public - Sllale of Florida
Comm-ssior M GG 084821
My Comm Expires Ma; 20.2021
Bunded lhroayh NJlmnal Kolar/Aw.