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�g PERIODIC PROGRESS REPORT
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Bureau of Beaches and Coastal Systems SL-I%2 (AMEND) Ml
Division of Water Resource Management
Mail to: Florida Department of Environmental Protection PERMIT NUMBER: (CORRECTED)
3900 Commonwealth Boulevard
Mail Station 300 FAKE GARDEN DEVELOPMENT,
Tallahassee, Florida 32399-3000
PERMITTEE NAME: INC.
If construction has occurred, please describe its maximum extent in the space provided below (If no work at all has
been'performed, please report "Not Started." If construction or other authorized activity has begun but no progress
has been made since the last report, please report "No Progress"):
CONSTRUCTION TO DATE INCLUDES:
2. All work performed as of this date is described above and is hereby certified to be in compliance with the project
description and plans approved by the Department of Environmental Protection as part of the permit and with all .
conditions of the permit. Locations and elevations of all construction as"of this date have been specifically verified as
applicable and have been found to complywith the project description, approved plans, and conditions of the permit.
No unpermitted construction or activity has occurred (Any exceptions to the statement above are to be described
and explained under Item Number 1 above, as part of this report. The explanation should state why the construction
or activities. not in accordance with the permit has occurred.)
3. The property owner.or authorized agent may sign these progress reports. However for.new armoring or major.
reconstructed armoring, the reports must be signed by an engineer licensed in the state of Florida following each
period in which construction has occurred.
(Seal)
Signature of Engineer (if applicable) Date
Typed or Primed Name of Enginee((If applicable)
Florida Registration Number (A applicable)
Signature of Property Owner or Authorized Agent (if applicable)
Typed or Printed Name of Property Owner or Authorized Agent
DEP Form 73-111 (Revised 1/04)
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FINAL CERTIFICATION
Bureau of Beaches and Coastal Systems SL-172 (Amend) N1
Division of Water Resource Management
-" Florida Department of Environmental Protection Permit Number: (Corrected)
Mail to: 3900 commonwealth Boulevard ,
Mail Station 300
Tallahassee, Florida 32399-3000 Permittee Name: Lake Garden Development, Inc.
This is to certify that the work under this permit for construction or.other activities seaward of the coastal
construction control line pursuant to Section 161.053, Florida Statutes, which was granted by the Florida
Department of Environinental Protection to the above named permittee, was inspected by the undersigned and was
found to be acceptable and satisfactory in accordance with the approved plans and project description and with all,
conditions of the .permit. All permitted construction or activities have been completed; and no unpermitted
construction or activities have occurred. Location and elevations specified by the permit and approved plans have
Veen verified and found to be correct, and topography and vegetation have been either preserved or restored as
required by the permit.
FOR WORK INCLUDING: Construction of a single-family dwelling, a wooden beach/dune walkover, a
paver -block driveway, a 10-foot by 10-foot wooden gazebo and placement of fill.
NOTE: Any deviations from the permit and any portions of the permitted work not actually
performed shall be noted and described in detail as an exception to this certification.
Signature of Engineer*or Architect Date
or Printed Name of Engineer or Architect
(Seal)
State of Florida Registration Number
DEP Form 73-115B (Revised 1/04)
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FOUNDATION LOCATION CERTIFICATION
Bureau of Beaches and Coastal Systems
Division of Water, Resource Management
Florida Department of Environmental Protection
Mail to: 39ob Commonwealth Boulevard
Mail Station 300
Tallahassee, Florida 32399-3000
SL-172 (Amend) M1
Permit Number: (Corrected)
Lake Garden Development,
Permittee Name: Inc.
This is to certify that.all aspects of the foundation location, as constructed, are in accordance with,both the plans
and the project description approved by the Department of Environmental Protectiomas part of the permit. The
foundation location certification is based upon such surveys as are necessary to determine the actual location
specified below:
Distancethe seawardmost piling has
been placed as measured
perpendicular to the coastal
constructioti.contiol line: Feet
Note: Any deviations from the approved plans and specifications shall be stated as an exception, to this
certification. No further vertical construction on the permitted structure is authorized until the Bureau of
Beaches and Coastal Systems has notified the permittee, in writing, that.this foundation location certification
has been approved.
Signature of Surveyor Date
Typed or Printed Name of Surveyor
(Seal)
State of Florida Registration Number
DEP Form 73-114B iNm 1/04)
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