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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, 13 ®L • lat 1. :::7 [3[7'4 Pen nu L(Ine . r-+ P) ft-G-P-,., (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 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. Vv VL 1,LG Proper O er Name (Ple a Print) Property Owner Signature Date STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS - —1 -/= DAY OF C)�)o� 20 GLJ , BY C,� " A/"-1 A O IS PFRSQ.0 LY KNOWN TO ME (0) OR WHO HAS PRODUCED AS IDENTIFICATION. SIGNATUREOF NOTA LIC O(Dq o , © COMMISSION NUMBER SLCPDSD Revised 04/11/2011 TYPE OR PRINT NOTARY (SEAL) of Florida 1i0o He~ C DW*n CpnrrrMion 028010 E tf0 O5/Z024