HomeMy WebLinkAboutFILLED LANDDOCUSign Envelope ID: 7BD9C3E8-55E6-4D9B-A01D-6BEF81B0373C
s _ _ PLANNING & DEVELOPMENT SERVICES DEPARTMENT
:. 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,
4210-323-0004-000-7, 10700 Carlton Road
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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.
Heather Phillips
Property Owner Name (Please Print)
�D -St -by:
Eh.afG.w' PG.i(li�s
OME�@R1O9 MtE9
Property Owner Signature
STATE OF FLORIDA, COUNTY OF S� Lucre —
11/11/2021
Date
ACKNOWLEDGED BEFORE ME THIS DAY 01"Decmb 20 a
BYr l 1 ! 1 WHO IS PERSONALLY KNOWN TO ME (LEI) OR WHO HAS
AS IDENTIFICATION.
STMATURE OF NOTARY PUBLIC TYPE OR PRINT
a COMMISSION NUMBER
(M ..•
BARBARA WATSON
=.• ;:: �ulY COMMISSION # GG 212928
r c'e`.•' EXPIRES: AUCUM 28, 2022
•'•,F•Of K� P• Boruled rnru Nota ry Publlc Undenellers
SLCPDSD Revised 04/11/2011