HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING- & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT DEC 2 12017
;6 H'TING
�Licie County, FL
I, the undersigned, am the owner of the following described property,
4425-703-0020-000-4 Lot 15 Riverbend
(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.
Scott Harala
Property Owner Name (Please Print)
Property 6wiTer Signature Date
STATE OF FLORIDA, COUNTY OF Broward
ACKNOWLEDGED BEFORE ME THIS `0\1 DAY OF 4 ! r20 17
BY Scott Harala WHO IS PERSONALLY KNOWN TO ME ( ✓� OR WHO HAS
PRODUCED
AS IDENTIFICATION.
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NOTARY PUBLIC
TYPE OR PRINT NOTARY
ffSIGNATUREUOF
6�La lq � 1
COMMISSION NUMBER
(SEAL)
SIVAN SHACHAR
MY COMMISSION # GG082944
SLCPDSD Revised 04/11/2011
EXPIRES April 10, 2021