HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGD41A AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Legal description/Address)
I
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, land in accordance with Section
7.04.01(D), St. Lucie County Land Development Co(
adequate drainage so that the immediate community
I further acknowledge that in granting this permit fc
St. Lucie County is neither obliged nor liable to pr
adequate drainage off my property which will n
community.
I shall be responsible for assuring
VILL NOT be adversely affected.
the development of this property,
'ide for, or maintain in any form,
adversely affect the immediate
'MCI CA nn3
Property Owner Name (Please Print)
as
Property ignature Date
1
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STATE OF FLORIDA, COUNTY OF_St I `A C 1 Q
ACKNOWLEDGED BEFORE ME
THIS _ D _ DAY OF T7 rI L 20 aU
BY _f��wVl CL M S WHO IS PERSONALLY KNOWN TO ME (�C OR WHO HAS
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PRODUCED AS IDENTIFICATION.
6G ATURRE 0 NOT Y PUB
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U l j U I COMMISSION NUMBER
SLCPDSD Revised 04/11/201 I
KICho Id! D, TY0n M 0 N
TYPE OR PRINT NOTARY
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,,,.•;�ptaY �r;A%,
RI�!g@LDQUGLAS JOHNSON
Notary Pub(lic - State of Florida
Commission # GG 084821
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OF FL,
My Comm. Expires Mar 20, 2021
Bonded hough Monal NolaryAssn.
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