HomeMy WebLinkAboutFilled Land AffidavitPLANNING &DEVELOPMENT SERVICES DEPARTMENT
• 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,
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(Parcel W/Legal description/Address)
for which I have applied to St. Lucie County for a Final Developmer>_t Permit. In
accepting this Final Development Permit, BP Number
that as owner of the above described property, and in accordance lwith Sectdion
ge
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring 7
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.
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Property Owner Name (Please Print)
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STATE OF FLORIDA, COUNTY OF_S �.
ACKNOWLEDGED EIEFORE ME THIS [ � O
13 Y DAY 20—V
L`i=� `�� w�-10 IS PERSONALLY KNOWN TO ME
L� PRODUCED OR WHO HAS
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AS IDENTIFICATION
S NATURE OF N rAR UBLIC
GGoByg�t COMMISSION NUMBER
SLCPDSD Revised04/11/2011
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TYPE OR PRINT NOTARY
(SEAL) '
RICHARD DOUGLAS JOHNSON
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Notary Public - Stale of Florida
C0mm,ss1or @ GG 084821
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MYComm. Expires Mar 20.20211
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