HomeMy WebLinkAboutFILLED LAND AFFIDAVIT:PLANNING_ "& DEVELOPMENT SERVICES. DEPARTMENT
Building &:Code Regulations .Division
IN
2300 VIRGINIA AVENUE .
FORT PIERCE, FL 34982-5652 . RECEIVED .
(772) 462-1553
NOV 0 a 2018.
FILLED LAND AFFIDAVIT STD. I,ueie o4n1YS Permitting
'SC4NNBy
.
I. the undersigned,. am the ownerof the following described property,
belt? C0
unty
4425-:703=004:7-000-6/RIVERBEND LOT 42/3045 NW RADCLIFFE. WAY, PALM CITY, FL
(Parcel.Id#/Legal description/Address)
for: which I. have applied to St. _ Lucie. County. fora Final -.Development . Permit. In .
accepting this -Final: Deve oprnent. 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 not liable to provide for,.:or maintain in any form,
adequate drainage: off my property which will not adversely affect the: immediate
community:
. . .
3r iu,n ma-s-i"
Property Owner Name -(Please Print)
t6h)
ropt rty Owner Signature Date.
STATROF FLORIDA, COUNTY OF . V. 1 (�V�4/, ZJ .
ACKN WLEDGED BEFORE ME THIS I DAY OF �i 1 �/�Ci 20 L�
BY �� • 1 WHO IS PERSONALLY KNOWN TO ME L) OR WHO HAS
PRODUCED n ve, 1 I I AS IDENTIFICATION.
flnmU 'rml M
.
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A SIGNAT OF NOT, Y PUBLIC _ TYPE PRINT NOTARY
(/�� COMMISSION NUMBER.
ANGE_A 5OKSODI-BAMINGriA( )
Notary PuDiic State o`•' : orida
`W `a ` Commission. GG 24y625 .
OF My Comm. Expires Aug ] 6. 2022
Bonded throt gh Nationa: Notary Assn.
SLCPDSD Revised 04/11/20.11 " .