HomeMy WebLinkAboutFilled land affidavitl
PT :A NfiTiN[:.4r iiE'.�li�,i.QP iFNT SERVICE-S DEPART-MFNT
Building & Code Regulations Division
FORT PIERCE, FL 34982-5652 r-
(772)462-2-1553 f R
FILLED LAND AFFIDAVIT DEC 16 2020
!. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
1301-615-0233-000-717106 BANYAN ST FT PIERCE FL 34951
(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
th."' »E ^:xmUrr nff thr(C whOxr:' r1Ce:.-rihcori nrnnoriv ».n.(1 1^ n nnr(jnn.C� xicith CpCL:OD
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.
1 llii'L11Cf ilk;1ti1UW1Cl1�C L11dL 1i1 'liu1L111g Lhis PCIIIIii lUi' L11C UCVC1UP111C11L Ul UILS PEOPUfly,
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)
&fte - 10 � � � a, oa, 0
Coperty Owner Signature Date
STATE OF FLORIDA, COUNTY OF S } , (+ ty
ACKN EDGED BEFORE ME � �_ DAY OF • e 20, Q
BY f i J/156n •�I Y'AG WHO IS PERSONALLY KNOWN TO ME C52 OR WHO HAS
QDUCED
ATURE OT NOTARY P LIC
COMMISSION NUMBER
SLCPDSD Revised 04111/2011
AS IDENTIFICATION.
1
TYPE OR PRINT NOTAR '
o�►� Notary Public Sta pf opda
+ CHRISTAL AS �UH
.. My Commission GG 983933
or Expires 05f1812024