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HomeMy WebLinkAboutFilled Land AffidavitST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT 2300 VIRGNIA AVENUE FORT PIERCE, FL 34982-5652 561-462-1553 FILLED LANDS AFFIDAVIT I, the undersigned, am the.owner of the foll F6 described property, 40 6- Sow_ oo �rQr© (t ID/legal des criptio /address) - for which I have applied to St. Lucie County for a Final Development Permit. In accepting this Final Development Permit, BP Numbered[/03% 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. Property Owner Property Owner Date (Print) (Signature) STATE OF FLORIDA, COUNTY OF , SWORN TO AND SUBSCRIBED /BEFORE ME THIS i 7 X4 DAY OF O�O, BY JQ' C� . r/ / I I1119P— WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS IDENTIFICATION. �� (seal) S NATURE OF NOTARY TYPE OR PRINT NAME OF N �AR NOTARY PUBLIC TITLE COMMISSION NUMBER SLCCDV FORM NO.: 011-00