HomeMy WebLinkAboutFilled Land Affidavit I
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
,. Building& Code Regulations Division
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE,FL 34982-5652
(772)462-1553 S E P 0 2 2021
St. Lucie county
FILLED LAND AFFIDAVIT Permitting
I
I,the undersigned, am the owner of the following described property,
1702 Juanita Avenue Fort Pierce FL 34950
(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 2106-0156 , 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 theldevelopmeni 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 adIversely affect the immediate
community.
Roderick Waller- Contractor
Prope Owner Name lease Print)
w 9/2/21 I
Property 6caner Signatu a Date
STATE OF FLORIDA,COUNTY OF
St Lucie
ACKNOWLEDGED BEFORE ME THIS 2nd DAY OF September ,20 21
BY Roderick Waller WHO IS PERSONALLY KNOWN TO ME iOR WHO HAS
PROD ED AS IDENTIFICATION.
Sophia Harris
SIGNATURE iJF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
Notary Public State of Fltl-da
SLCPDSD Revised 04/1 112 0 1 1 je,AN Sophia Hams
+� My Commission HH 005203
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