HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, Fl, 34982-5652
(772) 462-1553
RECEIVED
FILLED LAND AFFIDAVI
DE(: 14 ?018
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property, SCANNED
3322-501-0016-000-1/Parcel 15A at the Reserve Lot 13/7420 Laurels Placppt- BY
SI Ilcie County
(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.
Property Owner Name (Please Print)
1�" IL— /A-/,q,- s9
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF ✓/ Z/Z,/ a [�
ACKNOWLEDGED BEFORE ME THIS DAY OF
BY /!C�O
IS PERSONALLY KNOWN TOME OR WHO HAS
'SIGNATURE OF NOTARY PUBLIC
COMMISSION NUMBER
SLCPDSD,Revised 04/11/2011
OR
IDENTIFICATION.
(SEAT.)
y Paula E. O'Brien
NOTARY PUBLIC
_STATE OF FLORIDA
= Comm# FF970337
'r/acEW Expires3/1412020