HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT RECEIVED
Building & Code Regulations Division qp
2300 VIRGINIA AVENUE Permitting R 3 7qj�
FORT PIERCE, FL 34982-5652
(772)462-1553 St Ce e epart ent
CoUnty
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
4224-501-0070-000-9 / Treasure Coast Airpark Lot 70 and a 20 ft strip of land adi on S (5.46 AC) 115371 Skyking or, Port St. Lucie
(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 (Please Print)
-1 /7 12-0
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OFF
ACKNOWLEDGED BEFORE ME THIS J3 DAY OF 20 Zr)
BY WHO IS PERSONALLY KNOWN TO ME Q OR WHO HAS
PRODUCED AS IDENTIFICATION.
n
S A OF NO ARY LIC
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
i
(SEAL)
tiPpY PV�� HEATHER BURFORD
State of Florida -Notary Public
Commission # GG 193217
�iOF FlO �� My Commission Expires
February 08, 2022