HomeMy WebLinkAboutSLC Land Filled Aff - Noble Oaks - Wall permit App 2021PLANNING & DEVELOPMENT SERVICES DEPARTMENT
COUNTY Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
NO F(
16 � _ I, the undersigned, am the owner of the following described property,
co usm Y
/ 3y6q 21 3 000/
I n :`d c (Parcel Id#/Legal description/Addfess)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
_Tri46i � � 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.
Prope Owner lease Print)
Z�P erty Owner Signature Date
STATE OF FLORIDA, COUNTY OF 7 L— C ► O U t
ACKNOWLEDGED BEFORE ME THIS 0,1 b k DAY OF v�� 20 1
BY ��� �U `� WHO IS PERSONALLY KNOWN TO ME (EI OR WHO HAS
DLt.
SIGNATYRE OF NOTARY PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
%Q
LEMUEL R. JOHNSON ill
Notary Public • State of Florida
Commission # HH 99872
" DF
My Comm. Expires Jun 30, 2022