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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 property, 3-,,?7-76-a- 0007 - 00a? W73 i (Parcel Id#/Legal description/Address) G v / -0 6 a-V-' -1 -2- 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. L L t7c"s rop .rty Owner ame ase P oyv roperty Owne Si at (//� to STATE OF FLORIDA, COUNTY OF�y�(�� (If�-II�DY ACKNOWLEDGED BEFORE ME THIS DAY OF —20 -b . BYC 1 ) 0 1 1 1 LEI �iS /Y WHO IS PERSONALLY KNOWN TO ME (lam) OR WHO HAS — ILOF 0 C �j �+S TUREOFNOTARY PUBLIC r —7 fib- COMh1ISSION NUMBER SLCPDSD Revised 041112011 IDENTIFICATION. 1- i I c It i le t `Zahs 1 TYPE OR PRINT NOTARY (SEAL) �01ARY4. KULBIR K. BANSIL aQ �� NOTARY PUBLIC !STATE OF FLORIDA Comm# GG071200 cE W " Expires 2/8/2021