HomeMy WebLinkAboutFilled Land Affidavity
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,
g664](AZ-=(,- yob-q 61��s 46 cor(-,(a2l02o-2osN 1174-1 �2', 2o5S1 .
(Parcel IMILegal descripdon/Addressy %
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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 fzrther 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.
JOW MA1An1Cz&
Property Owner Name (Please Print)
Pro�seriy Owner Signature Date
STATE OF FLORIDA, COUNTY OF ' NA49l I t
ACKN
11OWLEDGE
D BEFORE ME THIS Z S DAY OF 6�p , 20 19
BY�JDW r IQc�tN C.Z�� WHO IS PERSONALLY KNOWN TO ME L_) OR WHO HAS
PRODUCEDALbL AS IDENTIFICATION.
SO4ATURE O OTARY PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
JQUE M Se-uSk'
TYPE OR PRINT NOTARY
JUIJE M SCALISE
"= MY COMMISSION # GG091020
�:'Fd►rvv' EXPIRES April 06, 2021
(SEAL)