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HomeMy WebLinkAboutFilled Land Affidavit '4 1 PLANNING & DEVELOPMENT- SERVICES DEPARTMENT 011 Building&Code Regulations Division 2300 VIRGINIA AVENUE FORT PIERCE,FL 34992-5652 (772)462-1553 FILLED LAND AFFIDAVIT I, the undersigned, am the owner of the following described property, oq �7fZ Deal - n©b -z , -r RM6T-A soJ71-IM1j19A�"s fsrrWes (Parcel Id#/Legal description/Address) 'r 3 o s. 6?1@44.v O'er for which I have applied to St. Lucie County for a Final ,Development Permit. .In accepting this Final Development Permit, BP Number 1Z?a/w®lJ-/ , 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. Prope O er Name(Please Print) P per Own%ergignature Date STATE OF FLORIDA,COUNTY OF ACKNOWLEDGED BEFORE ME THIS DAY OF < 20. BY 0 IS PERSONALLY KNOWN TO ME IEZ;�OR WHO HAS P UCED ASJDENTIFICATION. an �SIG4ATENTARPLIC TYPE OR P T RINT NO ARY SIG OMMISSION NUMBER aoApOy fto Notary Public State of Florida Danielle King y v My Commission GG 920935 '+pa Expires 10/27/2023 SLCPDSD Revised 04/1 1/2011