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HomeMy WebLinkAboutFilled lands Affi J PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772)462-1553 FILLED LANDS AFFIDAVIT I, the undersigned, am the owner of the followin described property, a- W I q - �- �� t ai Z.eSer Jt �tu rii( (Parcel Id4NLegal description/Address) 10 a1- 7 6+— I 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. 7"S U L7'1.o-5 Prop erl @r Name (Please Print) `rroperty Owner Signature Date STATE OF FLORIDA, COUNTY OF UCCtZ ACKN�O�//��'L''E11Dnn GyyED BEFO M.E_J�.� S_ DAY OF �JG{, W! 20�, BY I V LIVVl4AdSYtcs WHO IS PERSONALLY KNOWN ME OR WHO HAS AS IDENTIFICATION. �Y l9 X JZI- 1641 TYPE OR PRINT NOTARY NUMBER =E.p,—.11211�.�2 te of FlonoaanG 22143422 SLCPDSD Revised 08242010