HomeMy WebLinkAboutFIELD LAND AFFIDAVITSPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
�uCIE COIJIMr
I, the undersigned, am the owner of the following described property,
Riv _r Bran .h Fstates Lat 3 (0.5 AC)DR4098-1909)
(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.
I a __
Prop p ty Owner Name (Please Pririt)
I1) f U
Prope y Owner Signature D to
` I \ STATE OF FLORIDA, COUNTY OF V�
A OW DGED BE ORE ME THIS V� �/� DAY OF � , 20x%—
WHO IS PERSONA LY KNOWN TOME OR WHO HAS
PRODUC
ak-L�\-z3 Mccpu�
SIGNATURE OF NOTARY PUBLIC
COMMISSION NUMBER
TYPE OR PRINT NOTARY
(SEAL)
AS IDENTIFICATION.
SLCPDSD Revised04/11/2011 �"' CRYSTAL DAWN MOORE
�.
MY COMMISSION # GG066605
.�Iy, EXPIRES January 26, 2021
PLANNING & 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,
River Branch Estates Lot; (.0 5 A0)(OR4098-19nP)
(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.
Prop Owner Name (Please Pririt) r
' V
Property Owner Signature Dte
STATE OF FLORIDA, COUNTY OF
AQKNOWLEDGED BE ORE ME THIS `4 / DAY OF 20.
WHO Is PERSONA LY KNOWN TO WHO HAS
PRODUCE
SIGNATURE OF NOTARY PUBLIC
COMMISSION NUMBER
TYPE OR PRINT NOTARY
(SEAL)
AS IDENTIFICATION.
CRYSTAL DAWN MOORE
SLCPDSD Revised 04/11/2011 = ;
MY COMMISSION # GG066605
�4!
Rip
EXPIRES January 26, 2021