HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
' 2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
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1112 e 4 ?�
(Parcedescription/A rii —
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
acknowlege
that as owner of the above described property, and in accordance I. 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 NO 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.
Property caner Name (Please Print)
Po err
P h i�aature Date
STATE OF FLORIDA. COUNTY OF 9—. Lam; -e—
ACKNOWLEDGED DAY OF
EIEFORE ME THIS /
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By R Ifd ,n ,LL —
PRODUCED
4NATUaREOFN r-AR UBL(C
GG o8yeai COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
IS PERSONALLY KNOWN TO
20_Z
OR WHO HAS
AS IDENTIFICATION
IL�IAi QIR.W JU�+rv,f ON
TYPE OR PRINT NOTARYV
(SEAL)
..............,
RICHARD DOUGLAS JOHNSON
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Nolary PublfC L Shale of Florida
Comm,nor. k GG 084821
My Comm, Expires Mar 20, 2021
Bunded IAro+,yh Nalioaal Notary Assn.