HomeMy WebLinkAboutFILLED LAND AFFIDAVIT-1 PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
V FORT PIERCE, FL 34982-5652
NNED
BY (772)462-1553
St Lucie COuniy
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
1301-604-0118-000-1
(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.
Melvin Pickerill and/or Lenna Pickerill
Property Owner Name �(PileasPrint)
fi' o erty Ownex Signatures DaTe
STATE OF FLORIDA, COUNTY OF 5 + . l__, o C l -Q
ACKNOWLEDGED BEFORE ME THIS _ p)_S*4'�___,DAY OF F-l-__-_-__________ , 20__ 1__
BY �1U 1 o 0102-Le/ d I WHO IS PERSONALLY KNOWN TOME (C-S—) OR WHO HAS
PRODUCED 1 0 ` 0(C#_ b r_j ►JLQ,::S 1--I5.2',x&Q AS IDENTIFICATION.
( IGNAT_' )_TO�FjNOTARi' PUBLICf TYPF, OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
Stephanie Moure
Q� o� NOTARY PUBLIC
a STATE OF FLORIDA
$ Comm# FF957381
qc"E 19A% Expires 2/4/2020