HomeMy WebLinkAbout0253 ' 2645`72 6 ;
ORIGINAI - ~ /
APPL~ICATION N° ----s~s
~ TO THE
NORTH ST. LUCIE RIVER DRAINAGE DISTRICT
RFD #4, 80X 611 - A
FORT PIERCE, ~IORIDA 334S~
WHEREIN THE APPLICANT REQUESTS A PERMIT AUTHORIZING THE
USE OF DISTRICT FACIIITiES IN THE MANNER DESCRIBED BELOW:
(1) FOR WHAT USE OR CONSTRUCTION DO YOU WISH A PERMIT?
~~?tC ~ S / A?~/O it/ _ ! /OVs K S~o O /9~0 OQ i!10 %
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/~eC~ ~flx~~wi~J /~/io%~/ D~ 6•~!~SS L--~se~'SS
DU~".~ 1~•~~~~6E ,~i~h` 3
(Z) WHERE IS THIS WORK TO BE DONE? , .
St. Lucie County: Section:S~! Township: Range: _-~O~ _ f
Bloc,k: lot_~~ Subdivision: -
(3) NAME OR PROJECT NUMBER OF CANAL OR LEVEE INVOLVED: _ '~'na'L ~-~~o- - z
(4) OWNER O ~R~O-P,,OpSED WORK OR UCTURE:~ / ~I/
Name ~~f-l.~t~~~~~-Q~L_~/~' ~
I ~
(rMss~ print w trp~)
, Street or P. O. Box: _ v _ City: -L~Gi~State: _
i ~
! (S) PUMP, CULVERT AND OPEN CHANNEL CONNECTION:
~ a. Description of the area to be served is as follows (in-lude number of acres and submit location
~ drawing): ~ia/ ' //Q~~~~~~.f1-~~/~l// i/" :
I7
~ ~ ~r~ .
~ ,~3 ~,y-s- ~o~ y~ . ~ n~ ~ rt-- a . ~ a .
~ ,
~E G v f~ S .
b. This installation is for: ? irrigation only; ? drainage only; ? drainage and irrigation.
~ c. There are ? other connections ?no other connections serving this same area. If other connec-
~ tions are involved or contemplated, a separate statement of explanation of the interconnected sys-
tem will be necessary.
~ d. PUMP DATA:
~ Serial No. ~~Z'P~'___, rated capacity___ _ g pm, head ft.;
rpm, impeller diameter recommended horsepower d~ speed
~ Average head ft., actual horsepower 8 speed of p~ime mover ,
~ actual gear or pulley ratio - - - -
(6) HOW SOON AFTER RELEIPT OF PERMIT WILL WORK COMMENCE? - dsys.
`n' ' HOW MANY DAYS WILL BE R QUIRED TO COMPLE7E THE PROPOSED 1lI~ORK AFTER WORK ~
~ COMMENCES? days. - -
A work cornpletion date will be derived from the above information and will be indicated on the permit, '
if issued. If work is not completed by said completion•date, and no extension date has been applied for
'Y~ and granted; said permit will be invalid and any permission granted thereunder automatically with-
~ drawn.
~ DO NOT WRITE IN SPACE BELOW
AP?LICATION: R~vww~d Approwd
~ Preliminary Requirements ~R l,~), Permif Sedion~.tJ'~:(L'~.•~--
Operation ~ Msimainance _ , Inspectiori'8canch "
•
~ THIS APPLICATION IS INVAUD UNLESS IT IS SIGNED.
~ _ .
~ STATE OF FLORIDA s« .:a.
~r>
~ COUNTY OF ST. LUCIE `
Subscri~ed ar}d . sworn to before_ me this 4th day of June 197_3 .
tl F Olalr ~ .s.,~. 1 ` 1/ ~ .
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RcoK 21~ PAGf , , Mr co~~:.~;ss:~~ ~ . ,z~~s ~2~'`-'~
r' ~ ~r ~~•,.s.~ ? Ca~u4~ C~ n . Goodson, Notiary PLlt~11C ;n
= _ : _ . _ _ _ _ . .