HomeMy WebLinkAboutFilled Land Affidavit'i
1.
C = _IT w, r;_:;. PLAIVNING'� & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGTNIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
tall -b(3 b06
(Parcel Id#/Legal description(Address)
for which I have applied to St. Luc'
e 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 Cou ty Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL 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.
II
Property Owner Name (Please Prlint) —�
Pro er 23 Z \ P tY immature ---
Date
I
STATE OF FLORIDA. COUNTY OF
ACKNOWLEDGED EIEEFORRE M T ,IS
BY DAY OF b� �lQ.j1 20
_ A—
^ ,�
�-I IE 1 wH0 15 PERSONALLY KNOWN TO ME ORR
WHO f IAS
PRODUCED
"TibNATURE,OF NtffAR UBLIC
GGo$y a) COMMISSION NUMBER
I
SLCPDSD Revised 04/11/2011
�11 AS IDENTIFICATION
ILKAQ� •nl/�i :TO�%NiOR
TYPE oR PRrNT NU I ARYV
(SEAL)
a�•e
:
RICHARDDOUGLASJOHNSON
Nolary Public - Slale of Florida
Cammssior p GG 084821
M Comm Expires Mar 20.2021
BunCe4lmayti National Nalary Aisn.