HomeMy WebLinkAboutFilled Land Affidavit 0
.: PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE C
FORT PIERCE,FL 34982-5652 R'`E E°�*� D
(772)462,1553
DEC 19 2017
FILLED LAND AFFIDAVIT PERM11-TING
St. Lucie County, FL
1,the undersigned, am.the owner of the following described property,
3402-602-0141-00011 Indian River Ests-unitl-blk4-lots35,36,37 5113 Pinetree Dr Ft Pierce 34982
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 SLC 1702-0431 , 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.
0
Property �ner'Na� (Please Rrin ,
t2 /11 ) 17
Property nwner;Si� ature'= Date
STATE OF IF}A,COUNTY OF ��41y\,
ACKNOWLEDGED BEFORE ME THIS DAY OF G�� 20 I-
BY /a //er /V/eL 4//4c/ WHO IS PERSONALLY KNOWN TO ME( OR WHO HAS
PRODUCED Pho 1 l) AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER -
NO=OFFICIALFFICIAL SEALSR WOLFESt VirginiaMy Cos May 19, 2Q18SLCPDSD Revised 04111/201I 125 E. WOOD,WY 26537