HomeMy WebLinkAboutFilled Land Affidavit g �� PLANNING&DEVELOPMENT SERVICES:DEPARTMENT
r"Y Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,.FL 349824652
j (172)462-1553
i
FILLED LAND AFFIDAVIT
I
,'the undersigned,am-the Owner of"the.following described property;
451:1-811-0022A901"9 l 37 Aqua_Ra Dr Jensen Beach,FL 34957
(Pared ld#/Leg 'description/Address),
for which I'`have a hed; to" St Lucie "Coon for a Final Develo went Permit. In.
PP t3' p
-accep%ting this Final.Development Permit, BP Number . , T acknowledge
that as, owner of the' above described ro ert and in accordance with Section
p p. y�
7.04.01(D), St.Lucie:County Land Development Code,I shall be responsible for assuring
adequate.drainage so that the immediate.community WILL NUT'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,rdr.maintain in any form,
adequate -drainage off my property which will not adversely affect the immediate.
community.
Joseph,Pi6trzyk0skill
7nOwner,
pf erfy wner:Signature Date.
STATE OF FLORIDA,COUNTY OF
! {f .• i `� Z ,
ACKJiOWLEQGEQ BEFORE'bIETHIS DAY OF X
r i wH0 IS PERSONALLY KNOWN TO ME(�oR"wI#O HAS.i PRODUCED —� -' ��. AS IQENTIFICATION.
SIGNATURE OF NOTARY P.UBGIC TYPE OR PRINTNOTARY,
_COMMISSIONNi3MBER
� i"�e Notary Public State ol`ftorida
Lisa Xpoyin
My Camminion GG 1986t9EAL
R ' Expires 0.... . .0. .
SLCPDSD Revi' 6411 1/2 0 11,
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