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HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT © Building & Code Regulations Division 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5052 (772) 462-1553 FILLED LAND AFFIDAVIT I, the undersigned, am the owner of the following described property, (Parcel W/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 —b5LQ 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 Ow er Name (Please Print) /31 k'o Z roperly ero( cr Signa€ure Dale STATIi OF FLORIDA, COUNTY OF O ACKNOWLEDGED BEFORE ME THIS DAY OF � 20Z//, HY i j�11YJd mD S S POTS.�WHo is PERSONAE L Y KNOWN TO ME (Q) (lit WHO HAS PRODUCED J L l _.__ AS IDENTIFICATION. t] e r SIONATUREOF NOTARY UHLIC TYPE PRINT NOTARY J J�] 31�2 1I.SSION NUM F] J J Cassidy Berger €SFALI SV.R NOTARY PUBLIC STATE OF FLORIDA Comm# GG973629 sl_CPusD Revised ua/l Irzul I ray t 141, Expires 3/26/2024