HomeMy WebLinkAboutFilled Lands Affidavit 4 C .
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 'VIRGINIA AVENUE
WINEENiiinomw PORT PIERCE, FL 34482-5652
(772) 462-1553
FILLED LAND AF DAVIT
I, the undersigned, am the owner of the following described property,
132&233-0000-00017 3196 N Kings Hwy
(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 20IM517 1 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 aolmowledge 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)
i//
/
Property Owner Signature Date
STATEOFFLORIDACOUNTYOF
ACKNOWLEDGED BEFORE ME THIS Z (e DAYOF. . 7�nl u,�.__, 20. 21
BY Mc✓ IC4S Po /Z 1 MIANrJ WHO ISPERSONALLY$NOWNTOMBIL9 ORWHO HAS
PRODUCED, AS IDENTIFICATION,
V`1 C, UA, M a w +-kTE
SI OF NOTARY PUBLIC TYPE ORPRINTNOTARY
13 ZC>L4 COMMISSIONMIMBBR ICHRISTINA M. WHITE
1F + Notary Public • State of Itlorida
' 'A r` C01Fu1 Aon k GG 962711
. .„OFW My Comm. Expires Jun 13, 2024
Bonded through National Notary Assn.
SLCPDSD Revised 04/11)2011