HomeMy WebLinkAboutWS 29 - Filled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
r J� Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 4624553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner ofthe following described property,
5101 Armina Place, Fon Pierce - Lot29
(Parcel IdH/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Filial 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.
Property Owner Name (Please Print
Property er Sign.' re
STATE OF FLORIDA, COUNTY OF PALM BEACH
Date
ACKNOWLEUOED BEFORE MIi THIS i_Ll�,DAY
BY KEVIN BORKENHAGEN WHOISPP.RSONALLYKNO NTOME( ✓�ORwt1OHAS
PRODUCED
SIGN V M O�� PUBLIC
GG917671 COMMISSION NUMBER
SLCPUSU Revi�e004/I I/2011
KEVIN WIRTH
TYPEORPRIN'1' NOTARY
IDENTIFICATION.