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Filled 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, 2308-601-0131-000-3 / 422 Dusk WAY Fort Pierce, FL 34945 (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-firther 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. Wayne Smith Property Owner Name (Please /Print) /1 (W!5 l WiL l ature Daf STATE OF FLORIDA, COUNTY OF Jk • � kL A —741-1 ACKINA/O'WLL�EDGED BEFORE MMEHI E THIS ,�—DAY OF \ CCY�iC.�C ,20 i q . BY _�)�11"r)e �S IIkY 1 WHO IS PERSONALLY KNOWN TO ME (12OR WHO HAS PRODUCED ©�� axOMMISSION NUMBER SLCPDSD Revised 04/11/2011 IDENTIFICATION. � H��� TYPE OR PRINT NOTARY HEATHE&H�(RDEN CommissiBYYb�YrD 25312 :x �.; My Commission Expires August 28. 2020