HomeMy WebLinkAboutFilled land affidavit UC 009-1798
#22447(7626 S US Hwy 1)
PLANNING&DEVELOPMENT SERVICES DEPARTMENT
m 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,
3422-802-0005-000-2/PRIMA VISTA NUMBER ONE(PB 40-37)LOT 2(0.884 AC)(OR 1466-2032)/
7626 S US Highway 1,Port St Lucie,FL 34983
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number -,7004`t-LRO.0 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.
Xnon S.A.
P perty Own Nal lease Pri )
operty Owner Si ature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS =DAY OF n weyI'ibv,-- 20_1 ,
BY Q1 p/ � �4-r WHO IS PERSONALLY KNOWN TOME cu,OR WHO HAS
PRODUCED AS IDENTIFICATION.
caova- • 4 Y'
SIGNATURE O OTARY LIC TYPE OR PPJNT NOTARY
C.-J-ICOMMISSION NUMBER
(SEAL)
ot�tt°�e•; ANNIA E.GARCIA
Notary Public-State of Florida
SLCPDSD Revised 04/11,/2011 Commission:GG 351725
My Comm,Expires Aug 26,2023
Bonded through Natioral Notary Assn.