HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
' Building & Code Regulations Division
23DO VIRGINIAAVENUE
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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(Parcel Id#/t/Legal descriptio ddress) _
for which I have. applied to St. Lucie County for a Final Development Permi
accepting this .Final Development Permit, BP Number t. In
acnowlege
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 g
I further acknowledge that in granting this permit or the mentdofthis versely aol erty.
St. Lucie COLltlty is neither obliged nor liable to provide for, or maintain in any form
adequate drainage Off my property which will not adversely affect the
community. immediate
d4m s
Property Owner Name (Please Print)
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�ignature —�
Date
STATE OF FLORIDA. COUNTY OF -SV L A-L'. -4—
ACKNOWLEDGED EIEFORE ME THIS I I
BY e10.�h .-- DAY OF rAkr r IN 20 Z�
S WF10 IS PERSONALLY KNOWN TO ME
PRODUCED OR WHO HAS
AS IDENTIFICATION
S NATURE OF N fAR UBLIC "IL�AQ� K� . \..�_
TYPE OR PRINT NOTARY vy�tti�t)N
4 1 CUMWSSION NUMBER
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SLCPDSD Revised 04/11/2011 • I�
RICHARD DOUGLAS JOHNSON
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Com:nssiar p GG 0B4B21
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My Comm Expires Mar 20. 2021
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Bun(ed lAragn NabOndl Naldiy Assn.