HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
= Building & Code Regulations Division
2300 VRLGTNI.4 AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
1, the undersigned, am the owner of the following described property,
1301-610-0047-000-1 / 8701 Citrus Park Blvd
(Parcel W/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 1911-0361 , 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.
SCAN/Vet)
Antonio G Tenedorio St. Lucie
Property Owner Name (Please Print) C0U�t1
!2 /7 �Q
Property Owner Signature Date
STATE OF FLORIDA, COLNTY OF J,t L c I q
ACICNOWL)EDOED BEFORE ME THIS_. DDDAY OF �c-V�,b�_ 0_�.9.
BY &TV �'E Cn Tivsa north WHo IS PERSONALLY KNOWN TO ME(- )OR WHO HAS
PRODUCED r� 0 L AS IDENI'ffICATION.
SICkIL&TUKE OF NOTARY PUBLIC
COMMISSION NUMBER
SLCPDSD Rcciscd 04,11201 1
L'", i I //usas .61. v
TYPE OR PRINT NOTARY
(SEAL)
AStAWHUSSAIN
MY COMMISSION I FF 942303
EXPIRES: April 9, 2020
4h.�„�01 suded nru laget Notary ssn'ms