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 S(;AIVIVt:U
sy
St. Lucie r'nllnt
I, the undersigned, am the owner of the following described property,
3419-540-0057-000-81RIVER PARK -UNIT 5 BLK 45 LOT 3 (MAP 34/28N)(OR 519-1338)
(Parcel Id#/Legal description/Address) 260 SE Prima Vista Blvd, Port St. Lucie
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.
err Sci l (ti I kOnS
Pr pe ty Owner �Name (Plelse Print)
Property gnatu[e
STATE OF FLORIDA, COUNTY OF , In e-1 I CA S
Date
ACKNOWLEDGED BEFORE ME THIS I C—S DAY OF Vr (A(L .20 1—I
p \
BY 1 CI StI IGI. T�OMPrS WHO IS PERSONALLY KNOWN TO ME Cz OR WAO HAS
PRODUCED
SIGNAT E OF NOTARY PUBLIC
COMMISSION NUMBER
SLCPDSD Revised 04/112011
IDENTIFICATION.
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TYPE�ORi INT NOTARY
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Notary Public - State of Florida
'Commission # GG 046800
� My Comm. Expires Mar 5, 2021
'`Bantledlhrough National Notary Assn.