HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGI NIA AVENUE
FORT PIERCI; FL 34982-5652 SCANNED
(772) 462-1553 SCA �ItltltED
BY
FILLED LAND AFFIDAVIT fit, LucieQmM,
I, the undersigned, am the owner of the following described property,
1416 Lone Pine Drive, Fort Pierce, Fla. 3409-505-0016-000-9
(Pared IMILegal 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 properry, 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.
Zerty Ownelr/Name leap Print)
Prrop Owner Signature Wt /
STATE OF FLORIDA, COUNTY OF St. Lucie
ACKNOWLIDGID BEFOREME THIS S / I DAY OF 20 1
/16
BY._�-141i Af5, t4 WHOTSPERSONALL NORTi TO VTE(❑)OR WHO HAS
AS IDENTIFTCATION.
�S3 �� eE:7-
TYPE OR PR1NT OR
COMMISSIONMWBER ,p1�Y14 „
Joseph Gomez
-
Commission # GWON04
9.
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Expires: November 16, 2021
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Bonded thru Aaron Notary
SLCPDSD Ro ised 04111/2011