HomeMy WebLinkAboutFILLED LAND AFFIDAVITIDS 0 q-S-1
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT SCANNED
BY
�t Lucie County
I, the undersigned, am the owner of the following described property,
4201-113-0001-020-9 & 4201-113-0001-010-6 / 9675 Range Line Road, Port St. Lucie, FL 34987
(Please see attached legal descriptions)
(Pa reel Id#/Legal
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number 1708-0457 , 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.
iC EtTI-4 l�'1..c10 M �-
Property Owner Name (Please Print)
8 Zq Z10I
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF S—I Gu.Cte,
ACKNOWLEDGED BEFORE ME THIS Z.cffir DAY OF kAGLk —N , 20 0
BY 4d;i+�- —WHO IS PERSONALLY KNOWN TO ME E ' ) OR WHO HAS
SIGNATURE OF NOTARY PUBLIC
F fbOMMISSION NUMBER
SLCPDSD Revised 04/112011
AS IDENTIFICATION.
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TYPE OR PRINT NOTARY
Clydy RL Rlne
NOTARY PUBLC
STATE OF ON)N A.
Cam* FF9736/8
E*m 3127/2020
AUG 3 0 2017