HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, Fl, 34982-5652
(772) 462-1553
SCANNED
FILLED LAND AFFIDAVIT BY
�t 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 ldti/Legat 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(1)), 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 apy form,
adequate drainage off my property which will not adversely affect the immediate
community.
G Sib H- w, I tom,
Property Owner Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF i`/lA'r-�tn
ACKNOWLEDGED BEFORE ME TH1IS DAY OF 2r,
By C S" ` , V �1 • \ I�-�l WHO IS PERSONALLY KNO WN TO ME (LEJ OR WHO HAS
PRODUCED
SIGNATUREOFNOTARY PUBLIC TYPE ORPRINT NOTARY
CnG Lot ka0 _I COMMISSION NUMBER
IDENTIFICATION.
(SEAL)
MMCIADEMQ1ERAPJAND
_.• :,: MYCOMMISSIotinri91205
EXPOtES:FeWtany28,2022
SLCPDSD Revised 04/112011 „qRq;:� EyP1�g