HomeMy WebLinkAboutFILLED LAND AFFIDAVIT�� PLANNING & DEVELOPMENT SERVICES DEPARTMENT
9S , � - . y Building & Code Regulations Division
2300 VIRGINIA AVENUE
�r FORT PIERCE, FL 34982-5652
(772) 462-1553 RECEIVED
FILLED LAND AFFIDAVIT J U L 0 3'L 318
�� P con
, fl 51 _ Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
Parcel ID #3211-701-0006-000-1
(Parcel IM/Legal descrilidon/Address) _
for which I have applied to St. Lucie County for a Fin 1 D vel ment Permit. In
accepting this Final Development Permit, BP Number I acknowledge 1-4
that as owner of the above described property, and in accordadcc with Section a
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 he adversely affected.
I farther 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.
Ronald Rancourt
�Efepert6wn Name (Please Print) �7
�e+1 GJ
Signature tc
Property Own r
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS
DAY OF . 2c_1e ,
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R / TJ a
WHO is PERSONALLY KNOWN TO ME (12 OR WHO HAS
BY !./ r
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PROD U ED !J
AS MEN,TMICAATION.
IG ATIAIE PF NOTAfY PUBLIC
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TYPE OR PRINT NOTARY
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VARINIADENNES
=, :+ Notary Public - State of Florida
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