HomeMy WebLinkAboutFilled Land Affidavit Russ Macy I LISS!
iubiect: Filled I-and Affidavit
Da-'-e: May 18,2021 at 6:20 PM
Good Evening,
Attached is the filled land affidavit for you to complete.
Thanks,
Russ Macy
RW Macy Concrete Construction Inc.
772-577-1571
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04511W41
Building&Code Regulations Division
2300 VIRGIN'IA AVENUE
FORT PIERCE.1-1.3-19X2-565-7
(772)462-1553
FILLED LAND AFFIDAVIT
1, the undersigned,am the owner of the following described property,
q.,
(Parcel I&I/Legal c1cicription/Addrem%)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, 131) Number - q__- -a?A, I acknowledge
that as owner of the above described property, and in accordance with Section
7.04,01(D),St.Lucic County,Land Development Code.I shall be responsible for assuring
adequatc drainage so that the immediate cortunuility WILL NQ1 be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucia County is neither.obliged nor liable to provide for, or maintain in any form,
adequatc drainage off my property which will not advensciy afTect the intinediate
communit
Property Ohwner ic lease Print)
Property h% Date
ST.,kTE OF FUIRIDA.COUNTY OF -j
v n�r N CO'1N1 Y OF_.�4�-
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ACKN0%Tr.j)0FD 9EF.OVX�NIF THIS 161 PAY Ma
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14Y W114)IN 11060NAMY KNOWN TO ME,(L-0)(191%ItO I 1AS
9RnDUCr.r)- AS IDEN'l-IFICAtION
BrfanrrA Z�raer
SIGNATURE OF NOTARY PMIAC TWF OR PRIM'NOTARY (j
I
BRIANNA LYNN ZIRGER
Notary Public-State of Florida
Commission#HH 98489
MY Commission Expires
Februar'l 28. 2025