HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 SCANNED
(772)462-1553 BY
FILLED LAND AFFIDAVIT St. Lucie County
I, the undersigned, am the owner of the following described property,
3402-603-0042-000-0 6017 Buchanan Drive, Fort Pierce, FL 34982
(Parcel idWLegal 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.
Sent}- W � 1ICe.r�
Property Owner Name (Please Print)
Property Owner Signature. Date
STATE OF FLORH)A, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS Sr -A DAY OF . A (2(-k 1 I—.20 `�
CSLA' BY ki W • \ KU-N WHO IS PERSONALLY KNOWN TOME (El OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
W Ak aQ5 COMMISSION NUMBER
(SEAL)
MARCIADEANNEIiARUNDMYCOMMISSION/GG191205SLCPDSDRcAwd09/IIt2011
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