HomeMy WebLinkAboutFilled Lands AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
L c J - Building & Code Regulations Division
2300 VIRGINIA AVENUE
IIIIIIIIIIIIIIIIIIF FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
3403-331-0002-000-7/3 36 40 FROM NW COR HUNT'S S/D RUN N 330 FT, TH E 940 FT FOR POB, TH CONT E 120 FT,
TH S 170 FT, TH W 120 FT, TH N 170 FT TO POB (29-13) (0.47 AC)/702 ANITA ST FT PIERCE FL 34982
(Parcel 1d#/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 , 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.
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Property Owner Name (Please Print)
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P perry Owner Signature' Date
STATE OF FLORIDA, COUNTY OF L, �Cl
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ACKNOWLEDGED BEFORE ME THIS lvi DAY OF 20 �--c-
BY Z JL5 -Mel WHO 1S PERSONALLY KNOWN TO ME([ZbOR WHO HAS
PRODUCED �rLYJL S y_�l-1��� `�� ^C}Q3 ^� AS IDENTIFICATION.
STAA E O NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL) iL...-j
P0% LYSA JANE CAREW
Ml'COMMISSION4GG94EXPIRES: December I9,2
SLCPDSD Revised 04/11/2011