HomeMy WebLinkAboutRay Coburn Filled LandPLANNING & DEVELOPMENT SERVICES DEPARTMENT
® j - 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,
2417-233-0002-020-2 / 1404 HARTMAN RD FT PIERCE FL 34947
(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 , 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.
Property Owner Name
Signature
STATE OF FLORIDA, COUNTY OF F I (0 a Iy c ---
S�
D e
ACKNOWLEDGED BEFORE ME THIS oC DAY OF A to q u S 20 Z O
BY �q �/ CO bh r �• WHO IS PERSONALLY KNOWN TO ME) OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURP,bF NOTARY PUBLIC
CG 9 011 0 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
Co,sey (�'inKIe.,
TYPE OR PRINT NOTARY
(SEAL)
Y_sAl Notary Public State of Florida
Casey Binkley
t My Commission GG 908880
Expires 08/22/2023