HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, Fl, 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
MAY 2 3 ' 319
ST. Lucfe CO�nty, Pqrmitting
1, the undersigned, am the owner of the following described property, SCANNED
BY
5701 Buchanan Dr, Fort Pierce FL 34982 St I I Icie Cot intv
(Parcel IM/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 WELL 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 Owner Name ( lease
---- WFer—Si-- DaTe'
STATE OF FLORIDA, COUNTY OF V-1 () P A ot ct—
ACKNOWLEDGED BEFORE ME THIS DAY OF JVN��
BY P,01Z),kr+ M WHO IS PERSONALLY KNOWN TO ME LUI�OR WHO HAS
PRODUCED
SIGNATURE OF NOTARYPUBLIC
COMMISSION NUMBER
SLCPDSD Revmd 0411112011
AS IDENTIFICAT]ION.
8eila �- 7?/j t!L-)
TYPE OR PRINT NOTARY '
- - - - - - - - - - - -
gg", GAAfihENZ RbF
Notary Public - State of Florida
1 dommiselon # FF 957J967
My Cofrurr-'I�Pftn F10. 2020