HomeMy WebLinkAboutFilled Land Affidavit ,
PLANNING &-DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
1, the undersigned, am the owner of the following described property,
Sal I( LL4 84—
(Parcel I,dk/Legal d cription/Address)
for which I have applied to St, Lucie County for a Final Development Permit. In
accepting this Final-Development Permit, BP Number I acknowledge
that as -owner of the above described property, and in accordance 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 maintairt in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
— 0 &-' m
Property Owner Na (Please Print)
\ - -
Property ignaIure Date
STATE OF FLORIDA.COUNTY OF CJ
ACKNOWLEDGED IIE�FORE ME THIS_ DAY OF Y 20Z�J
BY�.(N 1 WHO IS PERSONALLY KNOWN TO ME OR WHO HAS -
PRODUCED 11 AS IDENTIFICATION
AQC� �tljalf'j Jo�N�ON
S NATURE OF N fAR UBLIC TYPE OR PRINT NOTARY
CtIr08413a.1 COMMISSION NUMBER
(SEAL)
............ RICHAP,O DOUGLAS JOHNSON
N91ary Punc-Suie of FlnnCa
• ttn��,r Com. oc M GG 084821
SLCPDSD Revised04/1I/2011 "'l4 v My Carom Expires Ma120.2021
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