HomeMy WebLinkAboutFILLED LAND AFFIDAVIT - SIGNEDPLANNING & DEVELOPMENT SERVICES DEPARTME~T
Building & Code Regulations Division COUNTY .
'lOR I DA 2300 VIRGINIA AVENUE
FORT PIERCE. FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
1. the W1dersigned, am the O\vner of the following described property,
4502-501-0558-000-7/372 NETTLES BLVD " JENSEN BEACH, FL, 3 957
(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 . cknowJedge
that as owner of the above described property, and in accordance ,ith 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 advers~ly 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 immed iate
community.
SCOTT D. CHAFFIN/SHARON S. CINAGLIA
Property Owner Name (Please Print)
r ' _/ _J L..<---t;7 ,,/~ . _
Properly Owne,' Signature Date
STATE OF FLOR1DA . COUNTY OF __S_T_._L_U_C_IE_ _ _ _
2ACKNOWL ED GED BEFORE ME TH(S 2-~ DA Y OF _~====--_____ __.20_-+l-_-e
By ~>4+0"'K:lf-bYliSI:'Q(ar£i\"(:~hwHOlS .; )ORV"l~ I HAS
,RODUC C ~ A"DENT'FlCA,,"'
SOCNA UR §u£i:4oc ~;TW~~~~~~~~~~~
c;G-q \ Lj~OQ OM."V!l S S(ON NU\1B ER iiA'if'-Y.~~~··. KATHLEEN GANNON -[*[ ':*~ MY COMMISSION #GG 914400
W· ..... :..~~i EXPIR~~~~uary 18, 2024 ':f.~~,~?,. Bonded TllrU'ifotaIY Public UndeJWriters
SLCPD SD Rev ise d 0 '1/ 11 /2 011