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HomeMy WebLinkAboutFILLED LANDS AFFIDAVIT0 PLANNING & 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, �=L TSqCIE 1 (Parcel Id#/Legal 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. C��iskl oQ1� sc�, Property Owner Name (Please Print) l©agl Property Owner Signature Date STATE OF FLORIDA, COUNTY OF ACKN WLEDGED BEFORE ME THIS U DAY OF t� C/� 20 / U BY [T ����% b Y I JCm IS PERSONALLY KNOWN TOME (Eb OR WHO HAS PRODUCED du G AS IDENTIFICATION. - adva otcwr--� SI A O OTARY PUBLIC / YPE OltPRINT NbTARYVF SLCPDSD Revised 04/11/2011 COMMISSION NUMBER (SEAL) e r °�� ; AUDREY B. HUMPHREY +: MY COMMISSION N FF 174772 e ;c EXPIRES; March 6, 2019 BoRded 'hruNotary PubriaUnderwriters