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HomeMy WebLinkAboutFilled Land Affidavit97 RECEIVED r fir. APR 0 5 2022 ~ St. Lucie County Permitting PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING &'CODE REGULATIONS DIVISION '2300 VIRGINAVENUE FORT PIERCE, FL 34982-5652 (772)462-1553 FILLED LANDS AFFIDAVIT I, the undersigned, am the owner of the following described property, 11414 _ col-©1%U, -MO-1 (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, Building Permit Number =3 --Q0 / l , I acknowledge that as owner of the above described property, and in accordance with Section 7.04.01(D)3, Filled Lands, St. Lucie County Land Development Code, I shall be responsible for submitting a stormwater grading plan assuring adequate drainage so that the immediate community will not be adversely affected. I agree to retain an engineer or other design professional if the stormwater grading plan fails; and, agree to hold St. Lucie County harmless for any future drainage rework that may be required as a result. 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. �oW y Pm1�y0ri Property Owner (Please Print) Property Owner Signature Date STATE OF FLORIDA, COUNTY OF SWORN TO (OR AFFIRMED) AND SUBSCRE3 ME OF PHYSICAL PRESENCE OR ONLINE NOTORIZATION THIS 2F REDAY OF 202a, NAME OF PERSON MAKING STATEMENT PERSONALLY KNOWN OR PRODUCED IDENTIFICATION FLDL TYPE OF IDENTIFICATION PRODUCED LD �� [. " J Cs t " 190 D " 1 ` E?l Y F� ''=CHERYL A. FINK SI TURE OF TARY PUBLIC TYPE OR PRINT NOTARY Notary Public -State of Florida '=Commission # GG 216951 COMMISSION NUMBERMy Comm. Expires May 13, 2022 (SEAL) SLCPDSD Revised 03/10/2022 Ordinance # 2022-2