HomeMy WebLinkAbout004 FilledLandAff JWW 372 Cyclone DrPLANNING & DEVELOPMENT SERVICES DEPARTMENT
' ® I� " ft—fiam Building & Code Regulations Division
11 - 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,
2308-131-0000-300-7
(Parcel ld#/Legal description/Address)
372 Cyclone Dr. Fort Pierce, FL 34945
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, 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.
Sa re)r-) n
Property Owner Name (Please rint)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF St Lucie
ACKNOWLEDGED BEFORE ME THIS 13 DAY OF
BY aa4Ko n (!j (�a'\ WHO IS PERSONALLY KNOWN TO ME ( ) OR WHO HAS
PRODUCED. AS IDENTIFICATION.
SIIGNApTRE O NOTAR IC TYPE OR PRINT NOTARY
Glr 1 y D `I(Jm b COMMISSION NUMBER
OV IO Notary Public State of Florida
(SEAL) ?o �. Nikki Cutler
s My Commission GG 189140
+? �' Expires 02/22/2022
SLCPDSD Revised 04/11/2011