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Filled Land Affidavit
PLANNING & DEVELOPMENT SERVICES DEPARTMENT Building & Code Regulations Division 2300vntow AAVENUE RrMEIVED FORT PUMCE, FL 34982-5652 CM)462-1553. JUN 17 2n2o FUMM LAND AFFIDAVIT ST. Lucie County, Permitting I, the undersigned, am the owner ofthe following described property, 01-000-q Z55 L for which I have applied to St. Lucie County for a Fmi al Development P "riEut�' in accepting this Final Development Permit, BP Number"ZQda 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 finther acknowledge that in granting this permit far 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.. Property Owner N lease Print) 1� Property, r Sipes D SrATEOF FLORIDA, COUNTY OF <A`LUue' Ail ACKNOWLEDGED BEFORE ME1TflS I� DAY OF T-W� BY OL)� 99�aS WHO IS PERSONALLY KNOWNTO ME 42�OR WHO HAS PRODUCED IDENTIFICATION. C e ��LoLr l - Ne4e SIONATUREOF OTARY LIC TYPE ORPRRYfN ARY ,�U�U CobausSIONNUMBER (SEAL) ••;y+{Le•.. DELANEY GOYETTE ` 4• " Commission # GG 070739 SLCPDSD Revised 04/11201 I ,'• o,-' Expires February 7, 2021 %%o ;; °+'• Banded Tlw Troy Fain Insurance 8003857019 PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION Survey Reauirementc The Board of County Commissioner approved a code change that will requires, copy of a current sealed survey when applying for a building permit for a primary structure or a banding permit for an accessory structure with a value exceeding $10,000. Ibis became effective July 1,1993. The guidelines are as follows: No Building Permit shall be issued for development unless a copy of a survey of the property on which the required activity is to be permitted accompanies the_application for building permit. All surveys shall demonstrate compliance with the Filled Lands Affidavit signed by the Property Owners (refer to St. Lucie County Land Development Code, Section 1.04.01.D.3.) and completely depict the following: 1. The location of the proposed development activity. 2. The relationship of the activity' under application to all adjacent property lines, and as may be required for the review of the application, all adjacent structures, improvements or natural features, including but not limited to the nearest building comers of all adjacect primary and accessory structures, pools and screened enclosures, fences, sheds, utility easements, wells, septic systems, driveways, culverts and any landscaping or ©fisting vegetation located along the property lines. 3. A minimum of two (2) elevations along each roadway on whichthe proposed activityborders, the -existing-ground elevation .atthe-approximate center of the proposed structure, the existing ground elevation along the side property lines adjacent to the proposed structure, and the proposed -.— finished floor elevation of the structure under application and finished grades for any adjacent struchres noted above in item 2. The proposed finished floor elevations must be consistent with the approved Health Department On -Site Sewage Disposal System Construction Permit if on -site sewage disposal is proposed All surveys submitted shall be prepared, signed and sealed by a Florida Registered Land Surveyor, in accordance with the provisions of Chapter 61G17-6, FAC, except those applications for interior modifications or construction, roofing permits not involving any structural alteration or additions to the area covered by the roof surface, or any other permit required activity that does not result in the expansion of any portion of the existing structures shall not be required to submit a survey. Accessory structures with a building value of less than ten thousand dollars ($10,000) shall not be required to submit a survey, but shall instead be required to submit a scaled plot plan indicating the location of the accessory structure and its compliance with minimum setback standards. Copies of original surveys meeting the above requirements may be submitted with any application for building Permit, provided that the survey still depicts the accurate location of all structures and other improvements on the property. Per Florida Administrative Code Chapter 61G17-6.006, paragraph 8, additions or deletions to survey, drawings by other than the signing party or parties is prohibited without written consent of the signing party or parties. SLCPDSD Rev 06/18/2010 219/06 coal