HomeMy WebLinkAboutFilled Land Affidavitl
C - ; jr_ -•. ;,.:, PLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGINLA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
, FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
311 7b1 6644 66d o IZb� (Parcel Idl#/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
acknowledge
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.
r,
Property Owner ame (Please Prl r,
Property ignature 6
Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED EIEFORE :I4VHO
DAY OF rBY � 20IS PERSONALLY KNOWN T E __j OR WHO HAS
PRODUCED
\AS 11-DENTEFICATION
S NATURE OF N rAR UBLIC �fL�AQ� Qllt� :T j pN
TYPE OR PRINT NOTARYV
GG'— g4PS�� COMMISSION NUMBER
(SEAL)
RICHARD DOUGLAS JOHNSON
SLCPDSDRevised 04/II/2011 'r��•�
Nolary Public - Slale of Florida
DonlrgssiorAGG084821
My Comm. Expires Mar 20.2021
BundedlNayhNationalPlalarpAssn.