HomeMy WebLinkAboutFilled Land Affidavit 113 SE Camino St_000679.pdfPLANNING & 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,
3419-515-0248-000-6 / RIVER PARK -UNIT 3- BLK 29 LOT 12/ 113 SE Camino St PSL
(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.
Donal ouilleseaux
Propr2wner Name nt)
'
P erty Owner Signature Date
STATE OF FLORIDA, COUNTY OF , �V V /
ACKNOWLEDGED BEFORE ME THIS _ DAY OF,Q�}!(i1"L��i� 20 j
BY CQ 1 � t I IL!�(3-.1 �( WHO IS PERSONALLY KNOWN TOME Q OR WHO HAS
n
PRODUCED Fl��f��( Ur-iQ C,riS „e— AS IDENTIFICATION.
S NATURE OF NOTARY P TYPE OR PRINT NOTARY
COMMISSION NUMBER
SLCPDSD Revised 04/1 I/2011
(SEAL)
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JUAN OSEJO
Notary Public - State of Florida Commission a HH i 303as
My Comm. Expires May t i, 2025