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HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT Building & Code Regulations Division 2300 VIRGINIA AVENUE ® FORT PIERCE, FL 34982-5652 A` ! (772) 462-1553 SCANED FILLED LAND AFFIDAVIT i I, the undersigned, am the owner of the following described property, 3©'fan GlaLes Cu4ci M %r�' 51, LC4 'e �L 349�C-� (Parcel Id#/Legal descriptim/Address) ' for which I have applied to St. �ucie County for a Final Development Permit. In accepting this Final Development i Permit, BP Number O)sq ' , 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. kctne-m LQ Mex- A,�" Property Owner Name (Please Print) �1 /ao 1 S roper Signature Date STATE OF FLORIDA, COUNTY OF O r'e lea 1 71 ACKNOWLEDGED BEFORE ME THIS o21 DAY OF Aa4 20�_, BY %QV C'li1 �q/ulpl (V1 I (,(rt/i WHO IS PERSONALLY KNOWN TO ME ❑Q OR WHO HAS PRODUCED (/ S 513 7 AS IDENTIFICATION. SIGN ? OF OTARY PUBLI r TYPE OR PRINT NOTARY f 0-7-7 COMMISSION UMBER (SEAL) E NotaryPublcJUSTINMIDGETT StaateofFlorida Commission c GG 107752 .q My Comm. Expires Jun 18.2021 Bcrdedthrcugl•NatioralMtaryAssr. SLCPDSD Revised 04/11/2011