HomeMy WebLinkAboutFilled Land Affidavit�, =A,,l : PLANNING & DEVELOPMENT SERVICES DEPARTMENT
- Building & Code Regulations Division:
_.
INIA AVENUE
FORT.PIERCE, FL34982-5652 .
(772) 4624553
FILLED LAND AFFIDAVIT
I' the undersigned, am the owner of the following described property,
:4502 501.0199 000 2..Nettles Island Inc condo section II parcel*13 and. pro. ata share -in -common elements: .
arcel-Id#/Le al descri tion/Address 1 1 rl { L3 +J5P
for which I: have applied to St. Lucie County for a :Final: Development Permit. In
accepting this -Final. Development Permit, BP Number , T 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.
40
-_John KuV'bikis (TR:)
Prop er Name ( ase Print
OSgrature Date
STATE OF.FLORIDA, COUNTY OF Saint Lude :. .
ACKNOWLEDGED BEFORE ME THISANJIDAY OF 20
Jo u eikis R
BY ... IS PERSONALLY KN WN TO ME: ❑(� OX WHO HAS: .
PR UCE
-AS: IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
`.r� = MISSION # GG 248769
YP
:AUTUMN
MY COMMISSION
EXPIRES: September 18, 2022
-:koF�.�; �c Bonded Thtu Notary Putdic Underwriters
SLCPDSD Revised 04/I1/2D11
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