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HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT Building & Code Regulations Division • 2300 VIRGINIA AVENUE FORT PIERCE,FL 34982-5652 (772)462-1553 FILLED LAND AFFIDAVIT I,the undersigned, am the owner of the following described property, 01A06 cj4(, ►/fij r2CL e5r ,XT IffPCE , FLA 3O15l (Parcel I&ILegal description/Ad`d'ress) 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. RE /414 rvl,- Property/ wn r a e(Please Print) Z7 7 Prope Owner Signature Date STATE OF FLORIDA,COUNTY OF ACKNO DGED BEFORE ME THIS DAY OF a46 20� BY ICAC . ��"�'!U���j Y-" WHO IS PERSONALLY KNOWN TO ME L OR WHO HAS PRODUCED AS IDENTIFICATION. SIGNATURE OF ARY PUB TI OR PRINT NOTARY COMMISSION NUMBER (SEAL) SLCPDSD Revised 04/11/2011 Y�P�B r. AUDREY 8.HUMPHREY 'r4 ` MY COMMISSION#FF 174772 EXPIRES:March 6,2019 '%� �� Bonded Thru Notary Pu61ic Underwrders •Fi OF