HomeMy WebLinkAboutFilled Land Aff K _z: PLANNING & DEVELOPMENT SERVICES DEPARTMENT
r Building& Code Regulations Division
2300 VIRGINIA AVENUE R ��v
FORT PIERCE,FL 34982-5652
(772)462-1553
JUL 2 8 2�21
FILLED LAND AFFIDAVIT ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
1430-331-0002-000/5 5500 Saint Lucie Boulevard Fort Pierce, Florida 34946
(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.
Theresa Fowler
Property Owner Name(Please Print)
7-28-21
'Raperry Owner Signature Date
STATE OF FLORIDA,COUNTY OF Saint Lucie
ACKNOWLEDGED BEFORE ME THIS 28th DAY OF July 2021
BY Theresa Fowler WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED y, AS IDENTIFICATION.
Cynthia Baker
SIGNA E OF NOTARY PUBLIC TYPE OR PRINT NOTARY
GG 366608 COMMISSION NUMBER
(SEAL
CyNTH1A BAKER
MY COMMISSION#W366608
EXPIRES:August 18,2023
SLCPDSD Revised 04/11/2011