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
SCANNED
BY
St Lucie County
I, the undersigned, am the owner of the following described. property,
3406-600-0005-000/2 - 4750 Magnum Drive, Fort Pierce, FL
(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 1603-0375 , 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.
' u M4Y E,: a
Proper er Name (Please Print) 10000
Property Owner Signature Date
STATE OF I4W�COUNTY OF�
ACKNOWLEDGED BEFORE ME THIS DAY OF 9?9fZlW 20 ,
BY lill'1 l t�- /NL WHO IS PERSONALLY KNOWN TOME (0) OR WHO HAS
P UCED '' ,, '' ,//�� AS IDE/fN�TTIIFICATION.
90-9,1
I TUBE OF NOT UBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(1VA PLENA LAWRENCE
nvn:= NOTARY PUBLIC OF NEW JERSEY
` =. �:•` LD. 0 2399811
` Y commission Expires 81304020
SLCPDSD Revised 04/11/201 1 �'