HomeMy WebLinkAboutFilled land aff r PLANNING & DEVELOPMENT SERVICES DEPARTMENT
MMEW Building &Code Regulations Division
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE,FL 34982-5652
(772)462-1553
FEB 0 3 2017
FILLED LAND AFFIDAVIT PERMITTING
St. Lucie County, FL
I,the undersigned, am the owner of the following described property,
Parcel ID: 2317-500-0009-000-5 Address: 1520 S Brocksmith Rd. Ft Pierce, FL 34945
Hays Subdivision (PB 71-12) Lot 2 (11.105 AC -483,734 SF) (OR 3892-858)
(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.
Peter B Hays Jr.
Property O er Name(Please Print)
P operty Owner Mgnature Date
STATE OF FLORIDA COUNTY OF
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ACrj�EDGED BEFORE ME THIS DAY OF 1K l.� r ,•/ter 20
BYer l l`'WHO 1S PERSONALLY KNOWN TO ME OR WHO HAS
WED AS IDENTIFICATION.
RY PUBLIC TYPE OR PRINT NOTAFff
MMISSION NUMBER
(TIMAY L.SCARMARDO
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Notary PvbAc=Slate of Floddf
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�•'., of�� ' CommleN #F on FF 50566
SLCPDSD Revised 04/11/2011
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