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
1,�
I, the undersigned, am the owner of the following described property,
09 36 40 S 1/2 of SE 1/4 of NE 1/4 of NE 1/4- Less S 165 ft of E297 ft- (3.78 ac) (OR 3520-2768)
(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.
Nicholas Tubito
Property Owner Name (Please Print)
10/1/18
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF St Lucie
ACKNOWLEDGED BEFORE ME THIS 1 st DAY OF October 20 18
BY Nicholas Tubito WHO IS PERSONALLY KNOWN TO ME Z OR WHO HAS
PRODUCED AS IDENTIFICATION.
Joshua A Morse
SIGNATURE O OTARY PUBLIC TYPE OR PRINT NOTARY
FF246008 COMMISSION NUMBER
•: J.OSNUA A ME -
_ B2aso, y
SLCPDSD Revised 04/11/2011