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HomeMy WebLinkAboutFilled Land Affidavit RECEIVED AUG 10 2015 PLANNING&DEVELOPMENT SERVICES DEPARTMENT Building&Code Regulations Division • 2300 VIRGINIA AVENUE 1-11111111 New FORT PIERCE,FL 34982-5652 (772)462-1553 FILLED LAND AFFIDAVIT I,the undersigned, am the owner of the following described property, TnA,cu,� Q1�ve�' aka,,- -�)ni�- �°�- (� 1.1�lr;3 Loi I I 6?15('S- I64 (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, 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. Property weer Name(Please Print) C'_ o/ (8/0As Property Owner Signature Date STATE OF FLORIDA,COUNTY OF c, 0 L ur l p ACKNOWLEDGED BEFORE ME THIS \C� DAY OF 20 L 5 Ij BY��n0+v11/ti 2 \ WHO IS PERSONALLY KNOWN TO ME(_)OR WHO HAS PRODUCED �' AS IDENTIFICATION. ,--? V\ V\ G ris SIGNATURE OF NOT PUBLIC TYPE OR PRINT NOTARY ' �S$1(ok C0MMI SSI0NNUMBER GIVENS . :` NNP of F\ocida D �.S�aDeo�6 2016 ExP�Ies EE 6586 Assn• Gommissio Na ionai Nola�y SLCPDSD Revised 04/11/2011