Volusia County Affidavit Of Drainage Control For Residential And Minor Commercial Construction printable pdf download

VOLUSIA COUNTY

AFFIDAVIT OF DRAINAGE CONTROL FOR RESIDENTIAL

AND MINOR COMMERCIAL CONSTRUCTION

OWNER/SITE INFORMATION:

BP#________________

1. Name of Owner____________________________________________

(Office Use Only)

2. Address of Owner__________________________________________

3. Phone No: Home ___________________Office__________________

4. Parcel Number for site _____________________________________

CERTIFICATE OF COMPLIANCE:

The undersigned owner of the above described property, being fully aware of the provisions of Section 104.1.7 Chapter 22, Code

of Ordinances, as amended, hereby certifies that development of the above described property will not result in:

1. Flooding of adjacent lands.

2. Blockage of existing drainage systems, natural or manmade.

3. The destruction of existing drainage systems, natural or manmade.

4. Erosion of fill or disturbed materials onto adjacent lands or environmentally sensitive areas (as determined by the environmental

control officer).

5. The destruction of roadside drainage swales, roadway pavement and/or shoulders.

6. Flooding of proposed structure during a 100-year-frequency storm or construction to an elevation less than that indicated on the

floodprone m aps as are available in the growth management department.

7. Inadequate on-site drainage in the vicinity of the proposed structure.

RELEASE AND AUTHORIZATION:

1. The undersigned hereby releases and holds harmless the County of Volusia and its authorized agents and/or employees from

any and all claims of damage of every kind and nature whatsoever to said property, or contiguous properties, arising from the

approval of this application or construction of required improvements.

2. The undersigned hereby grants unto authorized agents and/or employees of the County of Volusia the right to enter upon said

property for inspection and enforcement activities. Volusia County reserves the right to require the property owner to implement

reasonable measures regarding drainage control including, but not limited to, submittal of signed & sealed engineered drainage

plans.

______________________________________________

Signed

______________________________________________

Printed Name

State of Florida

County of ____________________

Sworn to and Subscribed before me, this _______day of _____________, 20____ by ________________________,

who is personally known to me or has produced________________________________________ as identification.

(Type of ID)

_______________________________________

_____________________________________

Signature of Notary Public, State of Florida

Print, Type or Stamp Name of Notary

Notarial Seal

Volusia County Affidavit Of Drainage Control For Residential And Minor Commercial Construction