HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
FAN2300 VIRGrN1A AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Legal descriptio Address)
)7
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
I: acknowledge
that ° as owner of the above described property, and in accordance with Section
7.04.0l(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT 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 Owner Name ( lease Print)
I
Pro I ( `
P er tY ignature Date
STATE OF FLORIDA. COUNTY OF S+-(C�
ACKNOWLEDGED EIEFORE ME THIS ___ �V.^�
(,() Q) . ,�,�.� u,� DAY OF ". `
BY�g WHO IS PERSONALLY KNOWN TO ME =S
(_) OR WHO HAS
PRODUCED _
AS IDENTIFICATION
S NATUREOFN FAR UBLIC IL�AQ� slfkj JO�+NtoN
TYPE OR PRINT NOTARY
G6-089691 COMMISSION NUMBER
(SEAL)
RICHARD DOUGLAS JOHNSON
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S LCPDS D Revised 04/ I I /201 1
Nolary Public - Slale of Florida
Commssior. p GG 084821
My Comm. Expires Mar 20.2021
Bundedhooyh Nabdnal Holary Assn.