HomeMy WebLinkAboutFILLED LAND AFFIDAVIT^ PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462.1553
FILLED LAND AFFIDAVIT RFc�
p on. Fo
�`C�e�epa
I, the undersigned, am the owner of the following described property, 064,
D�2p Cobblestone Dr, Fort -Pierce, FL sC
(Parcel Id#/Legal description/Address)
144" - &; *
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge ` 04Nj l
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.
'be, A0 W DAt) ► 0 SocJ
Property Owner Name (Please Print)
Property Owner Signature
STATE OF FLORIDA, COUNTY OF Brevard
9/24/2018
Dite
ACKNOWLEDGED BEFORE METFIIS 24 DAY OF September ,,a /a
BY WHO IS PERSONALLY KNOWN TO NIE Q) OR WHO HAS
AS IDENTIFICATION.
f
.SGlu6-4_ 6o1_
SIGNATURE OF NOTARY UBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER piibl4c Stole of Fionda
xY nu Notary
{SEAL.} _' °r1, Sandra Lone 4zo251
Comm,s;ion GG
`%,�'ov ExPses0871C,f�020
SLCPDSD Reused 04;1 If-101 I