HomeMy WebLinkAboutFILLED LAND AFFIDAVIT—PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 FORT PIERCE, FAL 349AVENUE52 SCgNNEp
(772) 462-1553 Sr 13
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FILLED LAND AFFIDAVIT tY
I, the undersigned, am the owner of the following described property,
2236-700-0009-000-3/LUKES LOTS LOT 9/ 16183 CARLTON ADAMS ROAD
(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 Own Name (Please Print)
Property _ er A ignattue , ,l I ,Q Date.
STATE OF FLORIDA, COUNTY OF • Lu C ` C) t/� /�
ACK\NnO `,WI,1" �nt�'fGED yByEFFO ME THIS ---DAY O 1 I U VL
BY `� " '1 11 1 1 , uN JwWI I nWHO IS PERSONALLY KNOWN TO ME L—) OR WHO HAS
PRODUCED l! 1 1 V GV 1 I ♦.:ILA IJL AS IDENTIFICATION.
1.- flnaelaOrSI �irmingha m
IGNA EI/O� F NOTARY PUB TYPE OR P T NOTARY _.
WZCOMMISSION NUMBER
(SEAL)
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r?o. ham;
ANGELA BORSODI-BIRMINGHAM
Public
SLCPDSD Revised 04/11/2011 `,�'tt� j a
.Notary -State of Florida
Commissions# GG 249625
'�?'or ti5� My Comm. Expires Aug 16, 2022
Barded through National Notary Assn.