HomeMy WebLinkAboutFilled Land AffidavitK...,.. j: = �-.:_, PLANNING.& DEVELOPMENT ;SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT Pfl�RCE, 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 Develop n.t Permit. In.
accepting this Final Development Permit, BP Number
that as owner of the above described property,and acknowledge
7.04.01(D) h lSection
St. Lucie County Land Development :Code, I shall be respons bleaccordance `fct r assuring
adequate drainage so that the: immediate community )ULL. NOT be adversely affected.
I further acknowledge that in granting .this permit for the de_ve.lopment of this property,
St. Lucie County is. neither obliged nor 1'ia,ble to provide rot, or maintain in any form, .
adequate .drainage off my property which will not adversely aff
community. ect the immediate
Property Owner Name P
( lease int)
Property 19nature -� ��
Date
STATE OF FLORIDA. COUNTY OF
ACKNOWLEDGED IIEFDRE ME THIS
—-- DAY OF AL�k Y•Ch. .
BY 20_J
IS PERSONALLY KNOWN TO ME
'r PRODUCED OR WHO HAS
AS IDENTIFICATION
S NATUREOF.N r-AR UBLIC
O 4 ComWSSION NUMBER
SLCPDSD Revised 04/I 1/201I
NT
s41ti�t)hNJ1 YPE OR PRINT NYV
(SEAL)
RICHARD DOUGLA'S JOHNSON
NOWY Publlc - Slale of Florida
Commssior, p GG 084821
My Lamm Expires Mar 20. 2021
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