HomeMy WebLinkAboutFILLED LAND AFFIDAVITDocuSign Envelope ID: B27BB8EB-5FB1-4B93-BB19-235D77A24D90
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,.
1327-701-0024-000-3 9624 Knollwood Lane Ft Pierce
(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 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.
Roger Stawski
Property Owner Name (Please Print)
Eqmtr
ocuSigned by:
tt,V' Sf aWS�t
®sir Signature
STATE OF FLORIDA, COUNTY OF2Am
8/2/2021
Date
ACKNOWLEDGED BEFORE `ME THIS DAY OF , 20 21
BY ICJ 'C Y� `� IA 11J S WHO IS PERSONALLY KNOWN TO ME (❑� OR WHO HAS
PROD ED ° AS IDENTIFICATION.
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SIGNATURYOF NOTARI PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
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DocuSign Envelope ID: B27BB8EB-5FB1-4B93-BB19-235D77A24D90
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,.
1327-701-0024-000-3 9624 Knollwood Lane Ft Pierce
(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 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.
Roger Stawski
Property Owner Name (Please Print)
EDopm;'
ocuSigned by:
�t,Y' Sf aWS�t
®ter Signature
STATE OF FLORIDA, COUNTY OF A�
8/2/2021
Date
ACKNOWLEDGED BEFORE ME THIS DAY OF �o " � V S� 20
BY Rope -A. S�- (, L 3 ItC WHO IS PERSONALLY KNOWN TO ME 10-1) OR WHO HAS
11
SIGNATUVOF NOTARY
COMMISSION NUMBER
`SgION
SLCPDSD Revised 04/11`e�t9. 202yRc�d; •,
W045 0 4�•
�pisLIC, 01 N O \\\\\ NIIN
AS IDENTIFICATION.
(k>nl (A- b e l ovt 7
TYPE OR PRINT NOTARY
(SEAL)