HomeMy WebLinkAboutFILLED LAND AFFIDAVIT PLANNING& DEVELOPMENT SERVICES DEPARTMENT
I-SM-LUCIE—
COUNTY 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,
10525 S Ocean DR Jensen Beach, FL 34957 4511-500-0008-000-2
(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.
Property Owner Name(Ple 0 r
� b
Pr erty r Signature fiat
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS �y DAY OF N&JI
BY<°u 6 0 WHO IS PERSONALLY KNOWN TO ME i)OR WHO HAS
PRODUCED l �y AS IDENTIFICATION.
4AGT� F ROTARY PUBLIC TYPE OR P T NOTARY
Hy
l!o 1'-)c��D COMMIS SION NUMBER
(SEAL)
'F wENDYA,BARD
SLCPDSD Revised 04/11/2011 Commission Hii 079898
E%pifes February 7,2025
p •+P,r'„+�° Banded TNu Troy Fain kWMAW 800-H5 7019