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FILLED LAND AFFIDAVIT
PLANNING & DEVELOPMENT SERVICES DEPARTMENT SCANNED Building & Code Regulations Division 2300 VIRGINIA AVENUE BY FORT PIERCE, FL 34982-5652 St. Lucie County (772) 462-1553 RECEIVED FILLED LAND AFFIDAVIT MAY 0 7 ?019 raT& kH§ln county, Remitting I, the undersigned, am the owner of the following described property, <!5/zf-- 3/2-0020 -0-©0- ( /300Nk(6IZ56 l ft�• (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. P6LM 2o15 keSiatenc� LLC. Pro Owner ame (Please Print) NmKb" 2 z1 2Ul w S gnature Date STATE OF FLORIDA, COUNTY OF�/ir,I.Q ACKNOWLEDGEDI BEFORE ME THIS DAY OF jjbjU GAL 20 BY,�//�I.G{ 1"f� Nd 01 WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRO.QED AS IDENTIFICATION. L f5a K. Lnio kSIGNTrURE FOT UBLIC TYPE OR PRINT NOTARY Uego ( J COMMISSION NUMBER (SEAL) LISA K PIPPIO SLCPDSD Revised 04/11/2011 ? MY COMMISSION # FFS81257 EXPIRES ApM 12.2020 rW J�00/6a F�glyNwrya�rvlm.aom