HomeMy WebLinkAboutFilled Land Affidavit - CompletePLANNING & DEVELOPMENT SERVICES DEPARTMENT
i
s Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34482-5652
(772)462-1553
FILLED LAND Al; i<IDAN'i'r
1, the undersigned, am the owner of the following described property,
1301-613-0031-004-51 LAKEWOOD PARK -UNIT I I- 8LK 137 LOT 31 (MAP 13112N) / 5814 Killarney Ave Ft. Pierce, FL 34951
(Parcel IM/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.
1 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.
Racf1 Lucius
roperty wner Name (Pleasc Print
Properly U gnslure Date
STATE OF FLORIDA, COUNTY OF\_�t Lu e.
ACINOWLFDGED BEFORE ME THIS. T)L DAY
BY __WHO IS PFRSONALLY KNOWN TO ME tE:1)OR WHO HAS
PROBl3CEB1„ AS 1 DENT! FiCAT[O +I.
SWN OF NOTARY PUBLIC TYPE Ok PRINT NOTARY
COMMISSION NUMBER
1 Ly[��RWk
NOTARY PUBLIC
-STATE OF FLORIDA
�` Comm# GG978800
SLCPDSb Revised 0411112011
1 Expires 4114/2024