HomeMy WebLinkAboutFilled Land AffidavitI �;-FLAPiNING & DEVELOPMENT SERVICES -DEPARTMZNT
r. , Building & Code Regulations Division
• 2300'VIRGiNIAAVE4UE
FORT PIERCE, FLL 34982-5652
(772) 462-1553
FILLED:LAND AFFIDAVIT
"'he undersigned, am the owner of the following described property,
2321-802-0005-000=9/Pine Hollow unit -two tot3(1.156ac)110610 Pine Needle: dr.FtMerce,FL.34945
(Parcel T61A Legal descriptioafAddress)
for which; I have applied to St. Lucie County for a Final Development .Permit. In
accepting j'this Final Development Permit, BP Number, , I acknowledge
that as owner 'of.`the above described properly, and -in' accordance with Section
7.04.0 1(D), St. Lucie County Land Development Gode, I shall be responsible _for assuring
adequate drainage -so- that. -the. immediate communi WILL. NOT be adversely -affected. -
I further acknowl a that in
edg granting lies permit for the development,of this property,
St. Lucie County, is "neither obliged -nor .liable' --to provide. for, 'or maintain in any form,
adequate idrainage off mw-not_-,,iadversely ":ffecthe immediate
E
communo.
Ptoperry Eh n'cr Name (Please Print) -
�1, . . OOM/2021
Property Owner Signature " Date
Acia�[rowr Ep' ED BEFOREMETMs nAY OF Uunt,. 20. .
21
WHO IS PERSONALLY KNOWN TO ME -(A ,OR WHO HAS
PRODUCED ! AS IDENWICATIC
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."r"r�+ U� Vl �l
SIGNATURE OE NOTARY PUBLIC TYPE OR MW NOTARI
_2CONID9SSION.NUMBER
A6iANDMEfiiM W"T`
* Comrtussion,�HH008693
o 'ExOreshoe 10,2024
?Ff�• BonAedTM►TroyFainlasuranoa8U0995+i019
Revised QVI V2611.
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