HomeMy WebLinkAboutFilled Land Affidavit-'; PLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIROMiA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
2 D D 1 U- 0 - 3 Ll 0 -f- m ct 141
(Parcel Wg/Legal description/Address) �� r
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
that as owner of the above described property, and in accordance I �v tlh Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible ft h assuring
adequate drainage so that the immediate communit g
I further acknowledge that in granting this permit or the developmentofthis affected.
St. Lucie COLIIIty 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 R ! 1 1 S
p ry Owtie Name (Please Print)
Property ignature I I I
Date
STATE of FLORIDA. COUNTY OF
_L. C' I
ACKNOWLEDGED EIEFORE ME THIS OF
B Y_ --DAY I�/l Cy, V� 20_ Z l
�'— �d Wl WHO 15 PERSONALLY KNOWN TOME � 6
PRODUCED l N) OR WHO HAS
AS IDENTIFICATION
S NATUREOFN rAR UBLIC s\ILNAQ� -4Ih� JU�+NJpH
TYPE OR PRINT NU I ARYV
"08q6fll COMMISSION NUMBER
(SEAL)
SLCPDSDRevised 04/11/2011 a�•:
L
IOnm\oM�Y:.
RICHARD DOUGLAS JOHNSON
Nolary Public - Swe of FlnriCa
Cam:n-ssior.kGG084821
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My Comm Expnes Mar 20. 2021
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Bonded lnrayh Ndboasl Nalary Aisn.