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,
17701 WAGONWHEEL LANE/ 3211-701-0009-000-2/ CARLTON COUNTRY ESTATES LOT 7
(Parcel Id#/Legal description/Address)
for which f 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.
KENNETH AND JOSEPHINE WILLIAMS
Property Owner Name (Please Print) r
Pro eri p Owner Signature y '� Date
I /c?tl Y. zr;C 6R3
STATF. OF F1:t1R'IDA, COUNTY OF ".0-rle.-Cke_
ACKNOWLEDGED BEFORE ME T�H'15 ,, _DAY OF , 2o�_.
BY en0 1 l� l,��j 1 / N �i WHO 15 PERSONALLY KNOWN TO ME (_) OR WHO 1IA5
PRODUCED ..-}e Ls' c.eAse AS IDENTIFICATION,
SIGNATURE OF NOTARY PUBLIC
O_ IC G G z S86-yFoMMIssION NUMBER
ISLCPDSD Revised 04/11 /201 1
TYPE OR PRINT NOTARY
(SEAL)
MICZHAE�- J,EWIS
Notary Public, Stale of New York
Registration #0'1 LE6258688
Qualified In +1Vestcihester County
Com—ssion Expires Appl 2. 2020