HomeMy WebLinkAboutFILLED LAND AFFIDAVITN
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 SCANNED
FILLED LAND AFFIDAVIT • Lucie Comity
I, the undersigned, am the owner of the following described property,
1301-603-OM-000-711akewood Park-Unil3 BIk 22 Lots 25 and 26 (0.42 AC -18. 750 SF) (Map 13111S) (OR 4033-1922 4034194:4120-2141)f7903 Westmont Drive. Ft Pien a FL 349514907
(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.
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Pr�71� Owner Name (Please Print
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Per"ty Owner _SJk _'_turd Date
STATE OF FLORIDA, COUNTY OF 4 0/ 1) leIVel�-
ACKNOWLEDG D BEFORE ME THIS 6-00/ DAY OF .29 /v
BY C,14 v/ A�� WHO IS PERSONALLY KNOWN TO ME CCIOR WHO HAS
PRODUCED
SIGNXTURE OF NOTARY PUBLIC
I f` 75-3AOMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
& C/2°r7ee /C F C(
TYPE OR PRINT NOTARY
(ONCE RADA
NOTARY PUBLIC
�@ STATE OF FLORIDA
y Comm# FF175396
si �F1a�� Expires 11111/2018
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