HomeMy WebLinkAboutFILLED LAND AFFADAVITDocuSign Envelope ID: 688E36CA-85E2-4661-8944-9A302C141711
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
•
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
3402-607-0289-000-5
(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.
E DocuSigned by: ad, f C,U,VYI SIiLIn.A. ��.,,�
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o�an�FF�nonaeFa -
;7V,QVgRer Name ((PleasePrint)
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Property Owner Signature
STATE OF FLORIDA, COUNTY OF ,,7 - ��CA C-
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2/9/2021
Date
ACKNOWLEDGED BEFORE ME THISJS� DAY OF ��-b� �� r'� 20�_,
BY �Y �cwn-i C4Y 1Skiv� `e'14 nc WHO IS PERSONALLY KNOWN TOME (11 OR WHO HAS
PRODUCED �� ��T'e'C�S �—%-CeVAS-e— AS IDENTIFICATION.
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SIGNAT F NOTAR P LIC
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V'A0%,9L 5O�0 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
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TYPE OR PRINT NOTARY
(SEAL)
KeOy Finley
lotaRp Notary Public
—state of Florida
Comm# HH082506
S�NCE ��N'b ExPlres 1/19/2025