HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
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FORT PIERCE,FL 34982-5652 aecrayea
(772)462-1553 � I'll
JAN
FILLED LAND AFFIDAVIT 4er SC�Luc a Cou ye t
I, the undersigned,am the owner of the following described property,
321S•801-M 14=-8/AERO ACRES BLK 1 LOT 4(2.03 ACKOR 3977•62BY18700 Mach One ORPort Saint tare,FL 34887
(Parcel W/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 -9 101-�Q f 15 C, 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.
.lames D Busby li and Kristina A Busby
Property der lame(Please Print)
0/1�z Z
Property er'Signature Date
STATE OF FLORIDA,COUNTY OF U,6
ACKNOWLEDGED BEi LIRE ME HIS (014k— DAY OF 1 .2001
BY r1S , WINO IS PERSONALLY KNOWN—)TO ME( )OR WHO HAS
PRODUCED 1 V AS IDENTIFICATION,
SIGN A URE OF NOTARY PUBLIC TYPIE OR PRIM NOTARY
65 4OMMissiON NUMBER
:•oi�pY!�e�., KEELY kII�AMILTON•BYRD
? '~�� �'_ Notary ppublic-State of Florida
Commission N GG 285394
My Comm.Expires Dec 18,2022
SLCPDSD Revised 0411 1/20 1 1
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