HomeMy WebLinkAboutFILLED LAND AFFIDAVITCOUNTY
r L 0 R I D A
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
RECEIVED
Nov 21 2018
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property, Sol
1407-313-0015-000-1 Ucf� �®
(Parcel Id#/Legal description/Address) Unt,
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.
Tristen Trefelner
Property Owner Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF S� . \.J C,\-'?,
ACKNOWLEDGED BEFORE ME THIS aA DAY OF N aJ 20A
BY'Nt 1 5-(Q. r'VV eT 0 V\ tf WHO IS PERSONALLY KNOWN TO ME E OR WHO HAS
PRODUCED "�- L Z L- AS IDENTIFICATION.
CJ�v�
SIGNATURE OF NO ARY PUBLIC TYPE OR PRINT NO —�
COMMISSION NUMBER 1:::y.,;
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0226
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ISLCPDSD Revised 04/11/2011