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HomeMy WebLinkAboutWater Well PermitsTATE oFr FLORIDA fkftl 11-1-411L.ICXflow jr'e, cons CRUCi, REPAIR, MODIFY, OR ABA(VON A WELL a�rtt¢a a �NTSouthwest x;,:,�Qa. PLE.E SE FILL 0V1 AL I, AWPI )CABLtF FIEL ttS r f_; Northwest ('t�2rfofc�s Recwimd Fields Where A ralicable) St. Johns River th Florida 7tt+3 i efts s(+�n crwtratcHH a,r ;lpfH1v0,4cl 14,comglothig 1. �� v M;,q corm told tanvard: ply the pY:rmlt app cation rd rtttt Suwannee River dpPdr, (Wa d ticilulutt nuturm wl?two cwlfcnalo- ^wb,� UDEP i 0Delegated Authot'igt (if AppfcablaP,_.. ,...,_,..__ t--, . �. „_, — Tr. nal Nama if Corabil alien2.�n`7 11) : n LP lr r) r 3. 1nt ) I - t:p u &n - may' W.' S.., "Marcel ID No(PIN) orAltamaatta KKe__y (Gerald ne) 4. "S�eyction or'Ca1id Grant � ``tp Itch p A;;� 5. r%r Ppk-k H 6. "'TU=) w`�jat) Ee9� _ 'Water Well Contractor's Address"- .._._.�- as i to ®A-- Pormn No... 59-31339 _ __- Florida Unique- PuMflit Styrullttions Required (Soo Altealled) 62.024 Quad No. _ p0ltnetrtlon No. CUP)WUP Application No. `Sint. ZIP _ 'TcalophonawNumber - - _�nn^mo�w � c� Unit Subdi.�Jheck if 62 Ad: 7. 'Typo of Work: _ Contttruction ... —Repreair __ _itatadifiCatian Ab�ndonitretnt _ - 8. 'Number of Proposed weU'.-i.._..__ . -Rq:4uri rur R f+udr, 67ktUitk ttnn, tx K6xnrMn 9.pacify Intended Use(s) of Well(s): pero stamp —'-Domestic Landscape lrrtyatiors _ _Actricr.:Itural irrigation --Site Investigation Bottled Water Supply �_RCereation Area Irrloahon; i ivasrOcjc - Monitoring ,_ _Public Water Supply (Llrnited Use/00H) NLo-s*ry,lrri;)ahon Test comaiiii ____Public Water Supply (Community or Non-CornmunityiDE-0 ) _ GoIr Qo Irarr1lrri{IBttronl Ffi/AC Supplly Geothermal Clr�as I Injection___I-tVAC Return CIasS V Injection: ReGrarge _ �Ccmmryrcia�InduU'fat t+sposrti r;ylu;tur Storage end Recovf ry , _ ..,Drainage Ramedielion: ..Recovery -.._,Air fair Spaor.ge __Other _leis jjr to Olflclal Use Only ,,,,,,,,Other (tiaoraiii) _ taus::. nl;r rat t os of v;M--' 10. Distant® from 3eplic System its20t) (t.-. j +11l Facil:t aeNcnptlon;_.4� -_�-12. [siimated Start Datet'j. �13,"Estimated Well. Depth tL "Eeatimdtsd Casino bepoi 1. '171mary Crsing oinmcatr r In. Clpen Hole: Frorn__ _ _To_, ,,,__ _ft, 14, Estimated Screen Interval; From IWLTo 15.`Primiary Casing Material; --—Black Sloal ~- Gaivenirea VC Staintass Steal NotCa:;od IS. Secondary Casirig. Telcabcape Casing lt:ner _ St rfLr.,e f atbing Uiernt)ter in. �_.. 17. Secondary Casing Material: Blaetc Steel _ Cal aniyod �.._. Pvc _ _ Stsinle� s Slca� l _ Other_ 1E °Mathod of Construction, R®pair, orAbandonmor;t, 1 uyer - - able Taoi !; fled otary po Sonic —Combination (Two or More Methods) �_ ,}trend Drivull (VB11 F16fnt, Stand Point) _Hydraulic Point (Direct Push) Horizontal Drilling Pluc�Y ocl b A roved M `th l Q 19. Pro used utin al Tar the Primary, 5eoondaty, and FramTo Seal Material o .__-..Athorfourcraol._L.__, Additional Caslrq): (__ _t3entotlitc_;f�3;�t r;cimcnt 01I*.er From _ Tc ,,,_Seal Materiel {Bento+iite- _ • _ . NrBrlt Corneht r'� - — �� } _,.._ From To �_ Seal Mabrial wBentot ite -Neat Ceme�It 'Seal .._Gt ....... Other, ^. _ _ From_. _.. b Material 13er •tliiS _Neal GE IT1Hj1I___ .._ ..__.. _ Qt11er�_, �_ 20 Indicate total number m exlstl 11 + i we s err see ,O6 List number of exivilin� unused walls art site 21.'Is this well or any existing well or water with raw�al on the m4ner's cotitiiyut�s properly cov€)red under a ConsumptivehAlater Use Permit (GUPlWUP) or CUPIWUP Application? _ Yes No (f yeas, co(nplofe the lolloWin;a: CUPfWUP No. _ District Well ID No. 22. Latitude. Lon()ttuCe 23. data Obtained From: _____GPS�- • 1Ivw+Hly enMdyural I vJ1 aru"ply PnH, Ytrl opwrats,. nrd®ny9Sr1 �o,'ryn,i!„ rwa"awn ,am pants n INrAtMllerJlxfM IWf"MI. dnMf Wr. Mr. Witro ro uil ts'1 gtN9wWf Rntr W � canuw.uuli. I rWYrawaYry, Wpt w egtal*,Wlw potiwu wl nl..QIt+t41>tlivLl 1p atgnaw, 11140!O!ry WHnuwl r1YA M11W fq"rC_6%1% ,.(owl GWum1w", 4 tXrt�uWu. taus .Reid *=0W3 Approval Grunted By Fee Received $— __ ___ ­—^ Rw THIS PERMIT IS NOT VALIO UNTIL PROPERLY SIGNED BV PERMIT SHALL RE AVAILABLE AT THE WELL SIT£ DURING DEP Form: 62-ti32.600(1) inaor0watod to 02.83' A00(1), FA, Dslum: _,� _,NAD 27 —NAD 83 WGS 84 mN G •a.kA/ I vurt.lr IicA I.,rt, ab n�ir r dUra :I Sr vYc 1tsl,Glyil:lpPi•q:.tf CKNia: 7'tp, mu4y,.4w ltPwomywi*l pMvPAMuraps, ofWa:l WftrNlMrs at myFkv411M"14Will Sol rtyill:n Hol,opm lot Z90o Mf.W811"+i �ohMron4w.pPirn(�drdt>1w�Io. mvl Ifial:llwm.nC.IMN.i 9u MNIM d➢Wt "'w i esucni P44aw az : .". 0-AN'"MOW to L&*#16 Pwilund of lion WIY.a or aNWpWcAu wft ac.•tnu •t•lu I (00.0 u'silo tlu ,i Olt' 0 .IRSOlim"L W WIpi111wawlt IIIt00aw hY Y4i W /3p-F f 1 i D. or Age Iss::e, [rtu li �'1 L LExpiration Date r HydroicgistApproval Na.: unc;H: Ort REPRr:S6N'r rtVC OF T 1IF- WMD OR DELEr3ATEq Bffe4llvc Wdo; OfJtreo► 7, 2010 g0 1 0/ ti .Cr St. Lucie HEALTH 5150 NT2541 County Health Milner Dr Department Port Saint Lucie, FL 34983 PAYING ON: #: 13ILLDoc#:56-BID-51 RECEIVED FROM: American Drillinq 2411 AMOUNT PAID: $ 345.00 3AYMENT FORM: 075121 PAYMENT DATE: 12/23/2020 MAIL TO: American Drilling 2411 405 SW 2nd St Okeechobee FL 34974 i i I :ACILITY NAME: American Drillinq 2411 'ROPERTY LOCATION: 405 SW 2nd St j I Okeechobee FL 34974 Lot: Blo k: Property ID: TION: EXPLANATION or DESCRI QUANTITY FEE 3 $ 345.00 -1 - Well Construction 1 , RECEIVED BY: AdamsC N a AUDIT I CONTROL NO. 56-PID-4835363 Note: 59-31337 - 59-31339 Penny Ln Citrus Rark Winter G In AS .' ' SURVEY EW pORSUIT PUBLIC fll% mm PLAN 26, BLOC 30 T B � )OD PARK 5, IN PLAT B OK 13, PACT' 5, 1 INCH 30 FEET SAINT Ly IE C Lu couNn NTY FLORIDA. NO IN F14D NAIL FNQ NAIL -WINTER GARDEN PXJVY� FN6 NAIL 8 70.0'-S is .9 ELV-19.87' Sa FND N/D BM LS 2391 ELV-19.87' 2X17- &P ;Se,647-3 "If(ld) ao.001(n FIR 5/6jjj - N 0.82' SIR 5/8- "ILB 7821' �1�1 N�l �L Q, r g W 0 0 i=ir Co 17,oq sarr U m p Opo I�STOSR? O RESIDENCE FFEAXXX LOT LOT 26 IFFE-22-95' BLOCK LOT 25 yu 54 !6 MCANT P NO' AWE" FOUND c U) Xx 9 I(,,), aw z is 71"1 ).E. 69—!4 -7 3 0 5/8- 7 Co *LI3 7821't "LB 7821 LOT 5 LOT 5 FFE-2195* FFE-24. V LOT 5 FFE-22.33' MOM, 1248-8 RH UM MZL.-Orr PROPOSED DRAWACE 10,480 SQ. FT. ARROW "Wy CENTURY CQ�MPLETE GROUND ELEVATION 8307 M qTER GARDEN 3KWY PRoposm arvAlION FORT P ERCE wo pRopffim CORRUGATED PSM . P.ROFESSIOM A MAIL - PIPE -- MAPPER SURVEYOR se WM a t A Hll T' ff U I H 9 vff Is La ® HCENSM Rum" LAKEWM PA 11 M&W r TO OF SUR my KNO THAT SURVEY FKD ' N R-A-wk A 03 OF AS is CEN QoRrOCOM of SW LUCIE COUNly. 1`100A, AS Eoma raZil we m Els Imme ,SET SETT. 7821' Z DATE OF FlaD SURVEYi 10/8/. V2C; SITE PLAN: to, 15/20 OF 17 FLORIDA IRON ROD CAP N MAIL W ON 47ZOV MT SCUT %o ITS Of EE MQW4ENT MN cow M, 1?0 - ooYop 9 AU' —r E P11111i 4- PROPEW LINES W911111 NOT E Z I3TARLISHIO Uft FENCE OR BUMNd 7M R/w - RtW-WAY 01, li= OR IMPROVEMENTS Ltv a BUT V MY Co W"I'm -mvwrwl DAIWO AND AIR Cow", Or IN, tu= COUNTY, FLCR PA mol. ilcc*7 OATC 2 UTIU4 W&5'" PAD' 0' UASM UPON My REM OF TH -FLM OMRANCE MAP- VMF WOW 'MV, 'r ) MiZ ly% COMM CLF JJA maim ma i a AS ARFAre. 14 , 1 � x LAIN, 7 P PLAT )F R.6%09 R Cal 0, US . OR E� MR - MEASURED A. NOTEZIOR mp CT IN - WAIER UM SURVEY FILE RUMM.- 2�-10-1 10 M CABLE RISER 0- ELLVA'ftCW SHM I 11=wj1y4wu11s11171 tm nuIPmE PJSM HERMN All TO kMERICAN VIIA71CAL 7821 DATUM OF 19=0aNA M THE I FLORMA PSGUMpApir M ELEMO RM RUE404M m (D POWER I= !(Cow ". m I QA7 IIJI W Bruadwally. sulto 11001. OVQ-*.r OF SURVEYS -FL 32705 Octobw 30, 2020 '977 K• II�►II�II►�I� : E RYQ ORE HOME • LESS MONEY 3091 GOVERNORS LAKE DR. SUITE 300 NORCROSS,GA 30071 PHONE: 336-282-3606 wIH,UC©zoto cis Z Q J d IC= 0 0 J LL i i PLAN # / ORIENTATION 1202 BLK /RH SERIES NAME: DIAMOND PLAN NAME: 3511246 BLK LAST REVISION 2.02 SHEET # GRP21.2