HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
' Building & Code Regulations Division
2300 VIRGrN A AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel fd#/Legal descriptiori/Address
for which I have applied to St. Lucie County for a Final Developineat Permit. In
accepting this Final Development Permit, BP Number
that as owner of the above described property, and in accordance i w tlh Section
7.04.01(D), St, Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that 'the immediate communit
I further acknowledge that in granting this permit for [he mentLL NOT be dofthi1s roleertd
St. Lucie COL111ty 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.
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Property Owner ame (Please Print)
ZjProperty ig�ature — --,23 Z(
Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGEDEIEFORE MET IS 01
DAY OF 1—
BY UV I ��j r� 20_�
Q �VHO IS PERSONALLY KNOWN TO E
PRODUCED OR WHO FfAS
AS IDENTIFICATION
S NATURE OF N rAR UBLIC
&-G!o8q6,11 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
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TYPE OR PRINT NU I ARYv —
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RICHARD DOUGLAS JOHNSON
Wary Public - SUe of Forida
Com n,ss,or. p GG 084821
My Comm Expires Mar20.2021
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