HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
Iloilo 2300 VIRGINIA AVENUE
FORT PjF-RCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner ofthe following described property,
a 8 -- 131 I �7c� — ' 1(
(Parcel Id#/Legal des i,ption/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 acknowledge
Sect-
7.ud.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
ion
adequate drainage so that the immediate communit
I further acknowledge that in granting this permit for the mentLL NO be dofthi!Y aofeeted.
St. Lucie Coutlty :is neither obliged nor liable to provide for, or maintain in any forty,
adequate drainage Off my property which will not adversely affect the immediate
community.
-
Property Owner Na (Please Print)
Property iglature
�74
Date
STATE OF FLORIDA. COUNTY OF_j5t L UC
ACKNOWLEDGED EIEFORE ME TH S
DAY O F s'l, L�j/ � ,��^ --
BY20_��77
4_.
�.� WHO IS PERSONALLY KNOWN TOME
PRODUCED OR WHO HAS
AS IDENTIFICATION
S NATURE OF N rAR UBLIC �IL�ACC ��q'h� Jo�N�oH
I YPE OR PRINT NOTARYV
4 COMMISSION NUMBER
(SEAL)
,: �� _; ; •.
RICHARO OOUGLAS JOHNSON
Revised 04/I I/2011 '^� �h�•:r =
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