HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
A%
Q1NNVOS FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
3424-800-0092-000-8 / 3528 Red Tailed Hawk Drive
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lu
accepting this Final Development Pe
that as owner of the above descr
7.04.01(D), St. Lucie. County Land De
adequate drainage so that the immedi
I further acknowledge that in grantin
St. Lucie County is neither obliged 1
adequate drainage off my property
community.
Property Owner Name (Please Print)
STATE OF FLORIDA, COUNTY OF.
ACKNOWLEDGED BEFORE ME THIS
BY (?ClMgknic, h I
PRODUCED
SIGNATUFdS7 OF NOTARY PUBLIC
(rid 8 $ 8k (,—COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
ie County for a Final Develo ment Permit. In
mit, BP Number 13DR , I acknowledge
)ed property, and in accordance with Section
/elopment Code, I shall be responsible for assuring
to community WILL NOT be adversely affected.
this permit for the development of this property,
)r liable to provide for, or maintain in any form,
which will not adversely affect the immediate
511(, l
D to
W
DAY OF M a rC K 120 1 T,
IS PE ONALLY KNOWN TO OR WHO HAS
AS IDENTIFICATION.
i�lar��re-f �c�ae-F'e►�
TYPE OR PkNT NOTARY
(SEAL)
w
=aS,BYP v0 MAR6ARliT SCHAEFER
MY MA183ION # GGS8886
�� � EXPM-S; Munch 30, 2021