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,
(Parcel Id##/Legal description/Address)
for which I have applied: to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
ack
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 L 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.
I
r0perty Owne Name (Please Print)
� I
Property ignature Z
Dati;
STATE OF FLORIDA, COUNTY OF t L - -r .
ACICN WLEDGED BEFORE MET IS
DAY OF y(j�r 20J
BY� /
WHO IS PERSONALLY KNOWN T M
PRODUCED L� C WHO FIAS
\AS IDENTIFICATION
S NATUREOFN r-AR UBLIC .�AP� a1R� JO"�NjON
TYPE OR PRINT NOTARY\
Gs-0896C11 COMMISSION NUMBER
(SEAL)
•1^qv o •.
RICHARD DOUGLAS JOHNSON
SLCPDSD Revised 04/11/2011
Nolary Pubic - sule of FloriCa
Comnssioc0GG084821
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My Comm Expires Mar 20.2021
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Bunded lhroa,yh National Nolary Assn,
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