HomeMy WebLinkAboutFilled Land Affidavitx
-- PLANNING & DEVELOPMENT SERVICES DEPAt rWNT
Building &Code Regulations Division
2300 V]RGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
_3lie? - - -0 1.57q _./
(Parcel ld#)Legal description/Address)
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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.
Property Owner Name (Please Print)
Pro ty Owner ftna a Date
STATE OF FLORIDA, COUNTY OF �5C' l �' C� `e
ACKNOWLEDGED BEFORE ME THIS/d )l--DAY OF - ' 20 °2 t '
BY 'ram e 1 P�1 WHO IS PERSO Y� NOWN TO ME d0) OR WHO HAS
PF=UCED AS IDENTIFICATION.
SIG "OFOPUBLIC TYPV, OR PRINT NO ARX
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 w
Notary Public State of Florida
:PRobin L Bowen
My Commission GG 298212
Expires 0210412023
FILE # 4869646 OR BOOK 4617 PAGE 2751, Recorded 05/26/2021 12:37:38 PM
dotloop signature verification: dH;+.!, .n f i 4 E
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NRTICE OF COMMENCEMENT
a�o
-5 o�q
Perin k No. Tax Folio No, -
Slate orNorlda County of SF, Lurie
The underslgned.heraby gives notice that improvementwill be mado to certain real property, and in accordalica with chap1er713, Florlda statutes,
the following Information is provided In this Notice of Cummenoment,
Legal Dasuiptlott of propci'ty; (and street addrkcs If available L
d"� lfS'�ILS�E=L
General description of hrprovetnbnu„��,(I.(��,P 'l`—�i�—�Jdl�i /��
ownar Information or lessee htfarmnllon If the Los`eP. canlrntud for the improvemel;tl
Name
Address f
Interbstlnprnpertyi
Name and address often slot a thigh❑ider(if dlf eranl From owner fisted abovo):
Contractor's Name;,, Port St. Ludo nrope1'ies,J.NQ.
Contractor Address: 201 SW Port St Lucie #103 Port St Lucie PL 34984 lhont Numbed 772-249-0086
Suraty [i(applicable, a ropy of the payment bond is nttochad); Amount of botld: NIA
Noma and addross: Phona number;
Landorlynmo; NIA ___Phone Number:
Legdor's addtami
Persons witfiln tile state of Florlda designated by owner upon whoin notices or other docuntehtsmay ba served as pr❑vlded by Sa01011
5 zIi 1) (jMarkrh4on alto�l
Nana: ^, f .Phone Number• 772-249-0086
Ad4re4st-2a1 SW Port St Lucie Blvd #103 Poxt St Lucie PL 34984
hi addhion to himself or herself, Owner designates Al11CJ10 Ira LdE3 UftO o7 Part St. Lucia Properties INC. o reculve-A copy of the
Lfcnai's Nollce as provided ln9et:tlan 713.13JiJ [b), flottda Statutes,
Phone number of person or entity designated by owner: _772.249-a086
INViration date bf 0atice of commencement; (the axplratioii data may notbahefore the cOmPlatlon of cot)struction and Anal liayment to the
contractor, but will be 1 Vaal- ream the data of recording unlass a different date Is specif fed)
WARNING To OWNER, ANY PAYMENTS MADE OY THE OWNER ARERTHE EXPIMMON OF THE NOTICE OF COMMENCEMENT ARE CONSiDERED
IMPROPER PAYMENTS Ui JINR Cl1APTER 719, PARTi, SCGT1oN 719,13, FWAIDA VATUrrES, ANO CAN RESIA iN YOUR PAYINGT ICU FOR
IMPROVEMENTS TO YOUR PiLOPERV. A NOTICR OP COMMENCEMENT MUST RE RK-ORDRI) AND POSTED 0 N THE J09 5IT3134FOR9 THE FIRST
INSPECTION. IF YOU INTENDTO OBTAIN FINANClNa, CONsULT WiTH YOUR (ENDER OR AN ATORNRI' BEFonL' COMMENCING WORK 09
RECORDING YOUR NOTICt OF CAMMENt EMENT,
Underpenalty or parJury, i declare that I have read the foregotngnoticeVcommencernantand that thefacts stated therein are true to the bastof
mv-knowledge and bellek I � ('", _
er or
(3igRate r 11[10tefoiflC1)
'rhe foraaoing instrument was acknowledgad haforo me this YNay oFMAY , 2&
ai - for
Type orauthority(o,g,ofriceorusteal Party oil hehattofwhom instrumentwas axacuted
tore o! Nataty rubric • State of Florlda)
Type, orstarep Corilmiss!oned Name of Notary Public)
R
Notary Public State of Florida
Robin L Bowen
My Commission GG 298212
Expires 02/04/2023
Personally kno *r produced Identlflcntfor�_,
Type of Identlfitxllon produced.