HomeMy WebLinkAboutFilled Land Affidavit7 ; _ j; :-.:^:,;. ;. PLANNING & DEVELOPMENT SERVICES DEPARTMENT
0 Building & Code Regulations Division
2300 VIRGINIA AVEMA
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel IdrY/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. accepting this Final Development Permit, BP Number In
ac
that as owner of the above described property, and in accordance ] witlh Sectdion
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible fc�r assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
f further acknowledge that in granting this permit for the development of this property,
St. Lucie COullty 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.
N. f� a v1 �Q m s
Property Owner Name (Tease Prinl)
Property gnature
Date
STATE OF FLORIDA. COUNTY OF S�- t"t , -e
ACKNOWLEDGED EIEFORE ME THIS
�� __ DAY OF MCt%.� 20 ZI
RO a �t dx n i"ct4m S WHO IS PERSONALLY KNOWN TO ME � �/
PRODUCED i- l !� 1 OR WHO HAS
{� 1 \AS 'IDENTIFICATION
"NAT:
UBLIC „ILNAQ[� Is 101� VE�hN j0l/
TYPE OR PRINT NOTAAYV
GGO— 84�a) COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
;; �G� o; p••, RICHARD DOUGLAS JOHNSON
Notary Public - Stale of Florida
nt��11 ComTssor.pGG084f121
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M Comm Expires Mar 20.2021
• • Buneed lNayh Nalmnal Nolary Assn