HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVE LOPME NT SERVICE, S DE PARTMENT
SCANNED
0 Building & Code Regulations Division
IBM- 2300 VIRGDUA AVENUE BY
kz=-� - 3EN F - FORT PIERCE, M 34982-5652 St. Lucie Countv
(772) 462-1553
FILLED LAND AFFIDAVIT
1, the undersigned, am the owner of the following described property,
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3415-501-0021-004-4� 6375 S US Hwy 1 Port St. Lucie, FL
(Parcel ldfl/Legal description/Address)
for which I have applied to St. -Lucie County for a Final Development Permit. In
accepting this Final Development Permit, B ' P Number 150fi-()29? 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 immed - iate 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.
Florida Power and Light Co.
Property Owner Name [Please Print)
Properij Owner Signature Datb I
STATEOFFLORIDA COUNTYOF c,,q4nt 1 ucip
ACKNOWLEDGED BEFORE ME THIS DAYOF ::run(�
B '?AUL
Y CjQ I- LA i�IA Ij HOJS PERSONALLYKNOWN TO ME (,)Oj OR WHO HAS
IDENTIFICATION.
-qsmantha J. Saucler
TYPE OR PRINT NOTARY
NUMBER
(SEAL)
< ft- Notary Public State of Florida
Samantha J Saucler
My Commission EE 184876
SLCPDSD Revised 04/1112011 Vlmvp Expires 0312912016