HomeMy WebLinkAboutFILLED LAND AFFIDAVITs� PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
RECEIVED - SQAf
FILLED LAND AFFIDAVIT St By Ej)
JUN 19 ;.018
UQle C
ST. Lucte County, Pe
9. Ounty
I, the undersigned, am the owner of the following described property,
9400 S OCEAN DR JENSEN BEACH FL 34957 3535.702.0001.000.4
(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 1A N O 4 -5 , 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.
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Property Owner Name(Please Print)
�be,sV-- G • 18' /5�
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF • L Q n Z // I
ACKNOWLEDGED BEFORE ME THIS ' DAY OF V UK �� , 20 T
BY E-0 VI)AO O(lGBS WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCFjp 011 / Y {_ A-r 1-1 C C kS _r AS IDENTIFICATION.
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SIGNATURE OF NOTARY PUBLIC
/ I' / L 77tCOMMISSION NUMBER
SLCPDSD Revised 04/11/201I
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TYPE OR PRINT NOTARY
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Stete ofceon GG 0l2021