HomeMy WebLinkAboutFilled Land AffidavitL
�,-•; _:= PLANNING & DEVELOPMENT SERVICES DEPARTMENT
L41611 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,
� 9 i�"rYl a 1 i
(Parcel Id# Legal description/Address)
for which-J—have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
acknowl
that as owner of the above described property, and in accordance I w I
th Sectdion
ge
7.04.01(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 ame (Please Print)
Property ignature
STATE OF FLORIDA. COUNTY OF V 1_ I Vl. C I t
ACKNOWLEDGED BEFORE ME THIS _ A __ DAY OF
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Dat&
y.� $��/ J LL N rr 20_ 4�
BY�"1—N ADM PRODUCED WHO WHO IS PERSONALLY KNOWN TO ME
( 1. 1 OR WHO HAS
ff `AS 'IDENTIFICATION
S �NATUREOFN rAR UBLIC �IL�AQC- ` qW V( NJOH
TYPE OR PRINT NOTARYv
"0846a1 COMMISSION NUMBER
(SEAL)
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RICHARD DOUGLAS JOHNSON
SLCPDSDRev ised04/II/20ii (1�l
Nolary Public - Slale of Florida
Commssior.PGG084821
My Comm. Expires Mar 20, 2021
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