HomeMy WebLinkAboutFilled Land AffidavitF
PLANNING & 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,
I
1311-900-Ol32 -ono-I 0126 omalfl G-f
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County fora Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, !and in accordance 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 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. I
OyAci rn Adam S
Property Owner Name (Please Print)
1 it W L2020
�Poperty ignature Date
I
STATE OF FLORIDA, COUNTY OF I J - V U Gf j
ACKNOWLEDGED BEFORE ME THIS 30 DAY OF � a n v G/(lA 20 aG
BY Ad 0 rn 7 WHO IS PERSONALLY KNOWN TO ME C>�,) OR WHO HAS
PRODUCED
SIGNATURE 0F NOT Y LI
G Cr 084 SaIL-COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
�WClAs JI.i�+l+J
TYPE OR PRINT NOT,WY
,EpI,�iICHARD DOUGLAS JOHNSON
?• .� = Notary Public - State of Florida
• ` Commission # GG 084821
My Comm. Expires Mar 20, 2021
Bonded bough NalkMW NotaryAssn.