HomeMy WebLinkAboutFilled Land AffidavitC PLANNING & DEVELOPMENT SERVICES DEPARTMENT
' Building do Code Regulations Division
2300 VIRGTNIA 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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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 with acknowledge
Sect'
adequate
to d St. Lucie County Land Development Code, I shall be responsible for assuring
on
adequate drainage so that the immediate communit g
I further acknowledge that in granting this permit for the developmentbe ofthils affected.
St. Lucie COLIIIty is neither obliged nor liable to provide for, or maintain in apro foertry,
adequate.
dequate drainage off my property which will not adversely affect the y
community. immediate
Rdoum S
Property Owner Name (Please Print) ----
Pro er
P ry ignature
Date
STATE OF FLORIDA. COUNTY OF -Sk- L.."L. *—
ACKNOWLEDGED EIEFORE ME THIS I
BY=C�sM --- DAY OF . Mkr-- 20_ S tVHO IS PERSONALLY KNOWN TO ME PRODUCED OR WHO HAS
11 AS IDENTEFICATION
S NATURE OF N rAR UBL[C �ILh
AQ� i, I _yUhN (ON TYPE OR PRINT NOTARY
4 I COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
,:'���� pi A •. RICHARD DOUGLAS JOHNSON
Nolary Public - Sldle of Flnnda
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II m Commsswc C GG 084821
My Comm Expires Mar 20. 2021
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