HomeMy WebLinkAboutFilled Land Affidavit J�
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
J - 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,
2327-502-0130-000-1 - Creekside Plat#lot 122 @ 9604 Potomac Dr
(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.'
Brian Davidson
Prnne.rty(1 e.r Name.(Please Print)
8/4/21
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF Brevard
ACKNOWLEDGED BEFORE ME THIS 4 DAY OF August 12021
BY Brian Davidson WHO IS PERSONALLY KNOWN TO ME 0 OR WHO HAS
PRODUCED AS IDENTIFICATION.
l/ Dina Parrino
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
�+.. DINAPARRINO
MY COMMISSION#GG 935643
A EXPIRES:February27,2024
Bonded ThruNolagPOUGUMenniters
SLCPDSD Revised 04/11/2011