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HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DE VELOPMENT T 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, 3224- I11 - 002 - 000 -Z (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. �Uf�hc�a 11 L�� Property O Name Please Print) Property O r Signature Date OL STATE OF FLORIDA,COUNTY OF 1 '`� ACKNOWLEDGED BEFORE ME THIS DAY OF/17g r 20 /7 BY rr WHO IS PERSONALLY KNOWN TO ME(�)OR WHO HAS PRODUCED AS IDENTIFICATION. aw&e&O p K" A /lo nn-/ s . d NATA�COMMISSION TARY PUBLIC TYPE OR PRINT NOTARY V NUMBER (SEAL) •, KIM A NOTORIS SLCPDSD Revised 04/11/2011 "` _ Notary Public-State of Florida ���+' Nr� 40, My Comm.Expires May 9,2017 ,�iFOF F�O��� Commission#EE 884154 pnuu`