HomeMy WebLinkAboutFilled Land AffidavitC �' r PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGrNIA AVENUE
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'G;F/Legal description/Address)
for which I have applied to St. Lucie County for a Fint. In
Development Permi
accepting this Final Development Permit, BP Number that as owner of the above described property, and in accordance I w with Sectdion
7.04.01(D) St. Lucie County Land Development Code, I shall be responsible for assurin
adequate drainage so that the immediate communit g
e aly
I further acknowledge that in granting this permit for the mentdversep
of this affected.
St. Lucie COL111ty 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
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Property Owner Name (Please Print) —�
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Date
STATE OF FLORIDA. COUNTY OF -SV L."'%. .0—
ACKNOWLEDGED 8EFORE ME THIS I t
By Uzi �__DAYOF rAkrLA,\ 20_-Z
KNOWN�/tf0 IS PERSONALLY KNOWN TO ME
PRODUCED OR WHO HAS
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AS IDENTIFICATION
S NATURE OF N rAR UBLIC TNOTARY OH
4 t COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/I I/2011
RICHARO OOUGLAS JOHNSON
�L Notary Public - Stele of FInrICa
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Bunded INo,,yl, National NolaryAisn.