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HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT 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, S ub cb VI,s1 on ov M (rI UY I-tn F r mS Hab-501 - DOUL4 - 00o -3 nLk + m+ I2 - ItSS tij i Q3 'F+ (Parcel Id#/Legal description/Address) (8.02 A (.) LoQ IIS2 - 1195Q 2-Mo S by-pcxsm%-Vb Qd F4 Pi;er(e fi 3 Q41 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. 0) (1 Y(ssa H am ri Cl< Property Owner Name (Please Print) Z( rop(11 L6 A erty Owner Signature Date STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS <pqcp DAY OF (1 © " " 1 20 BY I S MI"'LICHO IS PERSONALLY KNOWN TO ME ( )JOR WHO HAS PRODUCED REo SIN TU E ( F ARi. UBLIC ` COMMISSION NUMBER #HH 088119 711* GBEIC STASEO� SLCPDSD Revised 04/11/2011