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
I, the undersigned, am the owner of the following described property,
3211-701-0006-000-1 / Carlton Country Estates (Pb46-29) Lot 4 (5.241ac) (Or3820-61)
(Parcel Id#/Legal description/Address) 17900 Wagonwheel Lane, Ft Pierce 34987
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.
Ronald Rancourt
Property Owner Name (Please Print)
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r e w r nat� Date
STATE OF FLORIDA, COUNTY OFCa}- W 6 f—"
ACKNOWLEDGED BEFORE ME THIS 14F3 DAY OF d_u 1 Q , 20 leb
BY MYACI J► LA UM COu V- WHO IS PERSONALLY KNOWN TO ME ([:]) OR WHO HAS
PRODUCED 1 — D L .i�d� p,' 4 1 P-d2J AS IDENTIFICATION.
Q�OQ ITV V1CI CLIMPMl I
SIGNATURE OF NOT Y PUBLIC TYPE OR PRINT NOTARY
�� �COMMISSION NUMBER
Revised 04/11/2011
(sAafo Campbell
NOTARY PUBLIC
STATE OF FLORIDA
Comm# FF233777
Expires 5/21/2019