HomeMy WebLinkAboutFilled Land Affidavit - - - --�.-- PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
• L 2300 VIRGINIA AVENUE {
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
Nov 1 201�
BY: ......................
I,the undersigned, am the owner of the following described property,
3402-605-0072-000-5/INDIAN RIVER ESTATES UNIT 4 BLK 36 LOTI7/ 4609 PINE TREE DR, FORT PIERCE
(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 sly all 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';idevelopmerit of this property,
St. Lucie County is neither obliged nor liable to provi&1 for, or maintain M any form,
adequate drainage off my property which will not adversely affect the immediate
community.
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�RAYMOND WRIGHT
Property Owner Name(Please Print)
Property wner Signature ate
STATE OF FLORIDA,COUNTY OF
A WLEDGED BEFORE ME HIS DAY OF i 20
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BY S PERSONALLY KNOWN TO ME(_)JOR WHO HAS
P OD CE AS IDENTIFICATION.
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IGNATURE F NOT Y P LIC T PE OR PRINT NOTARY f
COMMISSION NUMBER
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FARA WARNANDEZ
=• MY COMMISSION #FFI172419
f
nd?'Y EXPIRiES October 28,2018
SLCPDSD Revised 04/11/201 I (407)39"153 FtoridallotarySerwce.Com
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