HomeMy WebLinkAboutWell Permit - ByersMission:
To protect, promote & improve the health
of all people in Florida through integrated
stale, county & community efforts.
DTI et.
HEALTH
Vision: To be the Healthiest State in the Nation
Ron DeSantis
Governor
Scott A. Rivkees, MD
State Surgeon General
Florida Department of Health in St. Lucie County
Conditions for Issuance of Water Well Permits
Effective July 24, 2017
• Contact the Florida Department of Health in Saint Lucie County (FDOH — St. Lucie)
prior to constructing or abandoning any well.
a. Call the FDOH — St. Lucie Well Line at 772-873-4936 or email
SLCDOH-WELLS FLHEALTH.GOV
b. Provide the following information:
i. Permit number
ii. Driller name
iii. Address
iv. Date and time to begin construction/abandonment
• A minimum of 24 hours' notice is required before constructing any public water supply
wells. Please call our main office at 772-873-4931 and speak with Environmental
Health Staff or provide notification by email to SLCDOH-WELLSaFLHEALTH.GOV
• Submit revisions to permit and/or site map and associated fee within 48 hours of well
construction or abandonment.
Florida Department of Health
St. Lucie County Accredited Health Department
5150 NW Milner Drive • Pat St. Lucie, FL 34983 Public Health Accreditation Board
PHONE: 772/462-3800 • FAX: 7721871-5360
StLucieCountyHealth.com
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STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCNeoax
REPAIR, MODIFY, OR ABANDON A WELL Pelmet No. 59-30996
❑Southwest PLEASE FILL OUT ALL APPLICABLE FIELDS Fbnda Unique 10.
Northwest ('Denotes Required Fields Where Applicable) Permit Stipulations Required (Sea Attached)
O St. Johns River J
❑South Florida The wafer waecentrecforrt mapanwGa P100.9
hu,and ro'—
OSuwanneeRiver nts term rwerGwg tM pamw appA'ea4on MfM 62.624 Ouetl No. Dol'xteetion No.
a pproprfaN, arose aernorey wnare app code
O DEP CUPIWUPAppl"tion No.
❑Delegated Authority (If Applicable) -
,. � [ ltc�4P L��x�2�069 Ct, �_� iaL&41 �Z in�r�
Owner, Legal Name if Corpo dress Ca St le Z, 'Telephone Number
z. Fs gz- Lo oSOAIe t f ET.1._��er� �1 3tlol(�____..__..___.__
'Well ,cation . Address, Rcad Name or umber, Clry
3.
'Parcel ID t0. (PI or Alternate Key I'O el, Lot Block Unit
4 L Gi
'Section or Land Grant 'To Ra 'CountSubdivision Check if 62-524; _Yes _- No
sr-� Is��lesas w t�`��,L 1 /y
3b� 3 6 -z
a Weil Contract rcense Number 'Telephone Number E-mail Address
B. • 5765' hF' a 4 M" Lw,.,J< O k o a ell,, d ow n I-
7.'Type of WOOL ,_&—Construction _Repair _Modification _Abandonment
•R
B. 'Number of Proposed Wells adon tar Repwr. Maalkatbn or Aeandenmml
9.'SpecWaleCed Ul lof Well(s): 0 n/]j
'y/V Domestic pe Irrigation _Agricultural Irrigation site Investigation �f l
`Beeled-7Pa1 r Supply _Recreation Area Irrigation _Uvesloek _Monitoring
Public Water Supply (Limited Use1D0H) _Nursery Irrigation _Test
Public Water Supply (Community or Non-Communily/DEP)—CommercialllndusWal _Earth -Coupled Geothermal
—Golf Course Irrigation _HVAC Supply S E P 8 2020
I Injection __HVAC Return
Class V Injection: Recharge _Commerciatflndustrial Disposal _Aquifer Stor4ge and Recovery _Drainage
Remedialion: _Recovery ___,_Air Sparge _Other IOncdoe)_,_,_ ,___, OH t611n�liA1&l��'OU
_Other toeeontet (Novi. No 0l,y.p^es or wane sr ermined v a glwo parmming awh�1l
10.'Distan,e from Septic System It s200 ft.11. Facday Description>S ' 1 V1 12. Estimated Start Dale
13.'Estimated Well Depth 13fl. -Estimated Casing Depth -O 11. 'PrimaryCasing Diameter in Open Hole: From_ToTfl.
14, Estimated Screen Interval: From_ _To_ it.
15.•Primary Casing Material: _Black Steel Galvanized _PVC _Stainless Steel
_Not Cased _Other:___
16. Secondary Casing: _Telescope Casing _ Liner _ Surface Casing . Diameter in.
17. Secondary Casing Materihk __Black Steel „__ Galvanzed __PVC _Stainless Steel __Other_,_,-,__.
1S.'Mothodo(Construclion, Repair, mAbandonment. —_Auger _Cable Toot _Jetted __Rotary _—__Sonic
,,,_,_ Combination (Two or More Methods) -Hand Driven (Well Point, Sand Point) ___Hydraulic Point (Direct Push)
_Horizontal Drilling _Plugged by Approved Method _Other mewee)
19. Proposed Grouting Interval for the Primary, Secondary, and Additional Casing:
From ____To Seal Material (�Bentonite Neat Cement Other )
From To Seal Material (Bentonite Neat Cement Other )
From „To Seal Material (__Benlonile Neal Cement OR1er______)
From _To Seal Material (_Bentonits__Nest Cement` Other )
20. Indicate total number ofexisling wells on she List number of existing unused wells on site
21.1s this well or any existing well or water withdrawal on the owner's contiguous property covered under a ConsumplivalWater Use Permit (CUPIWUP)
or CUPIWUP Application? _—Yes _No If yes, complete the following: CUPIWUP No.___._ District Well ID No.
22. Latitude Longitude
23. Data Obtained From: _GPS _Map __Survey Datum: NAD 27 _NAO 83 _WGS 64
to
a1VMYor .. / 'License ;S.....tm oi. ... ..-eni ...___..__...... .. .v yp, zi�'
Y
etl By __ ____,_,lesus Dale, _�__�_ Expiratlon Da1e�ZrjMydrologlat Approval _,--__NNaSReceipl No. Check No.18 NOT VALID UNTIL PROPERLY SIGNED BY qN AUTHORIZ@D OFFlCER OR REPRESENTATIVE OF THE WMD OR DELEGATED AUTHORITY THE
L BE AVAILABLE AT THE WELL SITE DURING ALL CONSTRUCTION, REPAIR, MODIFICATION, OR ABANDONMENT ACTIVITIES.
DEP Form: 62-Sa2.90D(1) Incorporated In 62.532.400(1), G.A.C. Effective Oew: October 7, 2010 °n^^ • ^' ^
7101
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PROPOSED
CONCRETE
24'DRIVEWAY
PROPOSED WELL
75' 1 1 a
14,67'
COVERED
PATIO 9 h o
10.33' - 0 A 37.50' 1
29.33'
o d
PROPOSED / ➢ F� �1.
`ATORY13BEDROOM /
INGLE YRESIDENCE /
33, f 7' 37.50'
ENTR 1,b0
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/ 20'
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Property Card Page I of I
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Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved.
Property Identification
Site Address: 8682 Parcel ID: 2323-701-0028- Account #: 14193 Sec/Town/Range:
LONESOME PINE TRL 000-2 23/35S/39E
Map ID: 23/23S Zoning: AR -I Count Use Type: 0000 Jurisdiction: Saint Lucie
County
Ownership Legal Description
Steven Reese Byers HIDDEN PINES ESTATES BLK B LOT 13 (1.00 AC)
Nicole Corinne Byers
2606 Creekside DR
Fort Pierce, FL 34981
Current Values Historical Values 3-year
Just/Market:
$38,100 Assessed: $38,100 Year Just/Market Assessed Exemptions
Taxable
Exemptions:
$0 Taxable: $38,1.00 2020 $38,100 $38,100 $0
$38,100
2019 $38,100 $38,100 $0
$38,100
2018 $38,100 $38,100 $0
$38,100
Sale History
Date
Book/Page, Sale Code Deed Grantor
Price
02-27-2020
4391 / 0469 0001 WD Spring (TR) Robert J
$62,000
07-07-2017
4024/1227 0130 WD Spring Robert
$100
09-01-1987
0558/2992 XX00 CV
$28,700
Primary Building Information
Finished Area of this building: 0 SF
Gross Sketched Area: 0 SF
Exterior Data
View:
Roof Cover: Roof Structure: Building Type:
Year Built: N/A
Frame: Grade: Effective Year: N/A
Primary Wall:
Story Height: No. Units: 0 Secondary Wall:
Interior Data
.Bedrooms: 0
A/C %: 0% Electric: Primary Int Wall:
Full Baths: 0
Heated %: N/A% Heat Type: Avg Hgt/Floor: 0
Half Baths: 0
Sprinkled %: 0% Heat Fuel: Primary Floors:
Total Areas
Finished/Under Air
0
(SF):
Gross Sketched Area
0
(SF):
Land Size (acres):
1
Land Size (SF): 43,560
Total Building Count:
1
Special Features and Yard Items
fype Qty Units Year Blt
All information is believed to be correct at this time, but is subject to change and is provided without any warranty.
W Copyright 2020 Saint Lucie County Property Appraiser. All rights reserved.
https://www.paslc.org/RECard/ 9/10/2020
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
PAYING ON: u:56-SF-2141272 BILLDOca:56-BID-4925409 CONSTRUCTION APPLICATIONM AP1554318
RECEIVED FROM: Homecrete Homes AMOUNT PAID: $ 660.00
PAYMENT FORM: CREDIT CARD 05124G PAYMENT DATE: 08/26/2020
MAIL TO: Steve & Nicole Byers
FACILITY NAME:
PROPERTY LOCATION:
8682 Lonesome Pine Trl
Fort Pierce, FL 34946
Lot,13
B
Block:
Property ID: 2323-701-0028-000-2
EXPLANATION or DESCRIPTION:
QUANTITY
FEE
128 - OSTDS Construction System Inspection Research Fee
1
$
5.00
-1 - Surcharge (Ail)
1
$
45.00
-1 - OSTDS New Permit Surcharge
1
$
100.00
-1 - OSTDS Construction Application and Plan Review,New
1
$
100.00
123 - OSTDS Construction Site Evaluation
1
$
115.00
126 - OSTDS Construction Permit (New or Mod, Amendment)
1
$
55.00
127 - OSTDS Construction System Inspection
1
$
75.00
133 - OSTDS Construction Reinspection
1
$
50.00
-1 - Well Construction
1
$
115.00
RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-4587313 _
Note: 59-30996