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HomeMy WebLinkAboutFilled Land AffidavitPLANNING & 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 G i A I 0VAW-1E=A XA-X—' , IM/Legal description/Address) RECEIVED ' \I 11 2C,9 9T.. Wf-'10 Q9llnty, permitting ,. j—Ij, 12 --T:SC.A/kd Dynes C VJ 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. C�i 1v/It<3ut Property Owner N me (Please Print) Property Owner ignature Date STATE OF FLORIDA, COUNTY OF 121H 7-11% ACKNOWLEDGED BEFORE ME THIS �� DAY OF 4CTOB/c �.20-, BY e' F RGI //k/mg WHO IS PERSONALLY KNOWN TO ME & OR WHO HAS PRODUCED 65a WOCOMMISSION NUMBER SLCPDSD Revised 04/11/2011 AS IDENTIFICATION. 1-01"r A• /GiUX�ei/ TYPE OR PRINT NOTARY (SEAL) �r 7_ � Nolvy PAft StVa or FbrkW f'%OLori A Moxiey t My Commheim GG 280148 qp0 Expires 111=022