HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE RECEIVED
FORT FIERCE, FL 34982-5652
(772)462-1553
I F OR 02
2020
FILLED LAND AFFIDAVIT I �-r, Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
3402-602-0052-000-0 4906 BUCHANAN DRIVE, FORT PIERCE, FLA.
(Parcel ld#1/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.
Pro `er)ty O er Name (Please int)
Property Owner Signal e
STATE OF FLORIDA. COUNTY OF ST.
7
Date
ACKNOWLEDGED BEFORE ME THIS DAY OF -�'(r I f i /� ALL
BY /t,f b{ / /^ (. rl".WHO 1S PERSONALLY KNOWN TO ME M) OR WHO HAS
PRODUCED N/A AS IDFNTiFICATION.
SIGNATURE OF NOTARY PUBLIC. TYPE OR PRINT NOTARY
76000MMISSION NUMBER
(SEAL)
SLCPDSD Revised 0411112011
Laura M. Cessna
NOTARY PUBLIC"
STATE OF FLORIDA
Can nN GG921300
1 Expires I0V9/M