HomeMy WebLinkAboutFILLED LAND AFFIDAVIT0
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
SCANNED
Fay H.LLED i LAND AFFIDAVIT
At Lucia COWIN
1, the undersigned, am the owner of th I e following described property,
4511-501-0298-000-4 1
(Parcel ld#/Legal description/Address)
for which I have applied to St. Ulcie County for a Final Development Permit. In
accepting this Final Development P6rmit, BP Number I acknowledge
that as owner of the above desdribed property, and in accordance with Section
7.04.0 1 (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.
Jerry & Kay Thiel
Property Owner Name (Please Print)
erty Ckwner Signature Dafe
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS '2 q! DAY OF 20
BY 7�1\ WHO IS PERSONALLY KNOWN TO M]5M OR WHO HAS
,Pre, sa, kQ me r
ARY PUBLIC TYPE OR PRINT NOTARY
(,Ee22-1� (P"8cOMMISSION NUMBER
(SE
1K
TERESA L KAMER
MY COMMISSION # FF227168
EXPIRES May 05, 2019
SLCPDSD Revised 04/11/2011 rbridallote:Xservice.con,
AS IDENTIFICATION.