HomeMy WebLinkAboutMohammed- filled land affidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
� COUNTY 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,
2326-600-0106-000-2/CREEKSIDE PLAT NO 1, LOT 101/8532 COBBLESTONE DRIVE
(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.
Ask— .-04A.-- 4
Property Owner ame (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF n T, Lu G k-
ACKNOWLjEDGED BEFORE
�,M,ET'H,IIS (_DAY OF ,�n p�-e MSCJC r 2o�a
BY Cjn"j 1 y� Q Q (YIAUL) WHO IS PERSONALLY KNOWN TOME (0) OR WHO HAS
ODUCED DRIVER LICENSE AS IDENTIFICATION.
17k aj-h,� vL-u�(A �-)T2
SIGNATURE OF
NOTARY PUBL TYPE OR PRINT NOTARY
G&' ;*a1bJ3COMMISSION NUMBER
(SEAL)
EN,,1P%Notary Public State of FloridaHeather VizzOMy Commission GG 262653SLCPDSD Revised 04/11/2011 Expires 11I13I2022