HomeMy WebLinkAboutFILLED LAND AFFIDAVITt
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT RECEIVED
FEB 0 2 2018
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
4221-312-0040-000-1 (14195 Range Line Road)
(Parcel Id#/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 , 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.
Michael Sole
PropertS Owner Name (P ease Print)
operty Owner Signature Date
STATE OF FLORIDA, COUNTY OFF. 11,,��
ACKyN��OWL1IDGEDI BEFORE ME THIS DAY OF �'�r,J a.r 201�
BY LY�1CY c l V'( SZIf WHO IS PERSONALLY KNOWN TOME OR WHO HAS
PRODUCED
AS IDENTIFICATION.
cep IOL
SIGNATURE OF NOTARY PUBLIC
TYPE OR PRINT NOTARY
•q2 1 COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 �0 14L Notary Public State of Florida
Fannie Slritk'and
? My Commission FF 992597
@o ,von Expires 05/1612020
SCANNED
6Y
St. LUQ1Q Ciclm*