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,
on- 10- tioo- � ��o�l d�,�v/+� 14
(Parcel Id#/Legal description/Address) G Y10 rl V
for which I have applied to St. Lucie County for a Final Development Permit. accepting this Final Development Permit, BP Number In
acknowledge
that as owner of the above described property, and in accordance I. with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community
I further acknowledge that in granting this permit fo`the mentNOT be dvethis ly affected.
St. Lucie County is neither obliged nor liable to provide for, or maintain in apny fortm,
adequate drainage off my property which will not adversely affect the immediate
community.
CAmL
Property Ovvner Name (Please Print)
Property ignature —_
Date
STATE OF FLORIDA, COUNTY OF V } �6 G I ,�
ACKNOWLEDGED BEFORE ME THIS 1 h�
�� DAY OF —M 64 20 p� BY d" 1 ' o "rHO IS PERSONALLY KNOWN TO ME
PRODDUUiC�ED� L ) OR WHO HAS
`AS IDENTIFICATION-
S NATURE OF N rAR UBLIC �IL�AQ� `lo�.NJ pv
TYPE OR PRINT NUARY\ —
y COMMISSION NUMBER
(SEAL)
•1�N� o','"
A
RICHARD DOUGLAS JOHNSON
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SLCPDSDRevised04/I1/2011 _ �"
Nolary Public — Slate of Florida
Commssor.gGG084821
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My Comm. Expires Mar 20.2021
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