HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
REcelvzo
FILLED LAND AFFIDAVIT MAR 0 8
7?14
PerrRitti, B
St. Luplpa� gent
I, the undersigned, am the owner of the following described property, SCANNED
BY
PONY PINES - UNIT ONE BLK A LOT 2 (1.84 AC) (OR 3874-1409) St. Lucie County
(Parcel Id#/Legal description/Address) 5949 Clydesdale Lane, Port St. Lucie FL 34987
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number j9,CR>-0jqq I acknowledge
that as owner of the above described property, and in accordafice 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.
n
Property erNaIne(Pleas int)
e Wner Signature gDate
STATE OF FLORIDA, COUNTY OF V�•ryX u C�l_V�
ACKNOWLEDGED BEFORE ME THI1 1S V DAY OF 1 L1L(1' I X .20 1 1
BY {, i " 1 1 WHO IS PERSONALLY KNOWN TO ME ( r OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
GG689c`7 COMMISSION NUMBER
(SEAL)
°* MARISSAPARKER
?A` MY C061MISSION900089227
SLCPDSD Revised 04/112011 i«w• p
EJ(PIRES: AprO 2.2021
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