HomeMy WebLinkAboutWater Well PermitsMission: Ron DeSantis
Governor
To protect, promote & improve the health
of all people in Florida through integrated
state, county & community efforts. J * s Scott A. Rivkees, MD
�
CJ0, LTH State Surgeon General
CA
Vision: To be the Healthiest State in the Nation RECEIVED
RECENEFA
FEB 17 2021 FEB 17 20l1
i emitting P,�partment Permitting Department
5,t:, 6p&le County St. Lucie County
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(a)-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-WELLSCD-FLHEALTH.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 Miner Drive • Port St Lucie, FL 34983 • . Public Health Accreditation Board
PHONE: 7721462-3800 • FAX: 7721871-5360
StLucieCountyHealth.com
STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT,
.. REPAIR, MODIFY, OR ABANDON A WELL 59-31281
"� ` Southwest FloidzUniqueID
PLEASE FILL OU7 ALL APPLICABLE FIELDS Northwest I Denotes Required Fields Mere Applicable) Permit Stipulations Required (See Attached)
�' tt -• St. Johns River
%South Florida rr;..::,, art,atra:,s :;:::s,:::1;�,:,I_t•�;
f� �� :F:f •'�,m.:r•.^. e7r,-rG:+]jny ;hd �.,:nsl ;pnl,caacn ;+;: 62-524 Quad No. Delineation No.
••.`; by li.i -\; _Suwannee River
CUP,•V,'UP Application No.
Delegated Authority (if Applicable)
1, Kt�.41 c., e,-r't f)lt- ' 0 h 32. A4A?c - t )le �• Iri. �(�' lLof ?_,oi t, -. (?• G
Owner. Legal Name if Corporation I Address City State ZIP Telephone Number
2. r4- 1,7,_ e...:_t 1=1.
Well Location - Address. Road Nar'ne or Number. City
3. I43L, - It c l - C'G•55 - 6CC - -7
Parcel 1D No. (PiN) or Altemate Key (Circle Otte) Lot Block Unit
440 f� S{ - 1 �c.; Check if 62-524:0 Yes Q No
Section or Land Grant Township Range County Subdivision
5. Timothy J. Huggins 11247 772-878•-6698 absolutewaterservioe@gmaii,com
Water Well Contractor License Number 'Telephone Number E-mail Address
6.258 SE Volkerts Terrace Port SL Lucie FI 34983
Water Well Contractors Address City State ZIP
7. Type of Work: 171 Construction ❑ Repair ❑ Mod)6cation❑ Abandonment
8. Number of Proposed Wells I peasat tcrp ck Mosifiacar
9. Specify Intended Use(s) of Well(s):
Domestic Landscape Irrigation Agricultural Irrigation ❑ Site Investigations
Bottled Water Supply ❑ Recreation Area Irrigation ❑ Livestock ❑ Monitoring
❑ Public Water Supply (Limited Use/DOH) ❑ Nursery irrigation ❑ Test F E B 1 D 2
❑ Public Water Supply (Community or Non-Community/DEP)❑ CommercialAndustria( Earth -Coupled Geothermal
❑ Class I injection ❑ Golf Course Irrigation HVAC Supply
❑ HVAC Return
Class V injection: ❑ Recharge ❑ Commercial/industrial Disposal ❑ Aquifer Storage and Recovery ❑ Drainage FDOH in St Lucie
Remediation: ❑ Recovery ❑ Air Sparge ❑ Other (Describe) ENMQWggTAL
❑ Other (Descnbe)
10. Distance from Septic System if <_ 200 FH i't 11. Facility Description c use- 12. Estimated Start Date
13. Estimated Well Depth =eft. Estimated Casing Depth -3 a ft. Primary Casing Diameter 2 in. open Hole: From To ft.
14. Estimated Screen interval: From To ft.
15. Primary Casing Material: Black Steel X Galvanized PVC Stainless Steel
Not Cased Other:
16. Secondary Casing: Telescope Casing Liner Surface Casing Diameter in.
17. Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel Other
18. Method of Construction. Repair. or Abandonment: Auger X Cable Tool 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 (Des` -ice:
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 ( Bentonite Neat Cement Other )
From To Seal Material { Bentonite Neat Cement Other )
20. Indicate total number of existing wells on site 0 List number of existing unused welts on site
21. Is this well or any existing well or water withdrawal on the owners contiguous property covered under a ConsumptivePMater Use Permit (CUPIWUP)
or CUPANUP Application. Yes X No If yes. complete the following: CUPIWUP No. District Weil 10 No.
22. Latitude Longitude
23. Data Obtained From: GPS Map Survey
• :•2•i :. i. ��::�::: "^C S:r%:__:%_'a2i :.'- �IT.J i._..�� ___. F'= __ d"^'
se e�•• �• a^ cat+ - bra _• -s cr � ccvero c•. - _c
^4[t. : •2-:Ml,l+ ri a••_ r G'::Yr• -.3 aeft�3G^ - .�•itr •'•]:.^,: 1 .l C
e;r. e A �r.:a'; _ '-at?�a;:a-
[:.PU:JtJr •!C•]r: Fl [r'r i =1i t•. _l V..• a-ys aav ;muM_^+r J;i V Cogm a'"-_t'. fTWv m1 .V:3.c . x \/
oG53W<r.'�^-:._rv::C G1 M.i- '.{ � �.F=n.•:�:vp,a!Cr •.ti�:�.Cvnf G: _'S roe: \
11 47
Sicfiature of Co or 1 tense No.
Approval Granted By Issue Date
Datum- NAD 27 NAD 83 WGS 84
r•5t5:'SL3:24^- •" •�Y • - c _- $FZ`i- . - •_v,'I(i � _ `=5 1 n • - e
•::f-.:>-. M1ssr --' :r=rs� .�(c •^s!\:t^�=e�?n ` ;; :y scctss
GC7 = :k+ c:. .. ;: '^ ,!ca.! .+...: r C•r' . aw-7=t A %. e'llr. eK cy mw yP'n.,
3 z c
gnature er or Agent Date
Approval
Fee Received S Receipt No. Check No.
THIS PERMIT IS NOT VALID UNTIL PROPERLY SIGNED BY AN AUTHORIZED OFFICER OR REPRESENTATIVE OF THE WMD OR DELEGATED AUTHORITY. THE
PERMIT SHALL BE AVAILABLE AT THE WELL SITE DUPING ALL CONSTRUCTION. REPAIR, MODIFICATION. OR ABANDONMENT ACTIVITIES.
DIP Form, 52-532.900(1): Incorporated in 62-532.400(1; F.A.C. Effective Date: October' 2010 Page 1 of 2
Tf
SOUTHWEST FLORIDA WATER MANAGEMENT DISTRICT
2379 BROAD STREET. BROOKSVILLE FL 3460-4 6399
PHONE. i3521 798-/211 ori8-00t423-14
'NWUV.SWFYVit1ID.STATE.FL US
ST. JOHNS RIVER WATER MANAGEMENT DISTRICT
a4g REiD STREET PALATKA. FL 321'8-1429
PHONE: ;385; 329-4E00
1,NM.S JRWMD.COLi
NORTHWEST FLORIDA WATER MANAGEMENT DISTRICT
152 bVATER MANAGEMENT DR., HAVANA. FL 32333-= 12
(U.S. Highway 90 10 rr les west of Taliahasseei
PHONE (850) 539-5999
'✓)V VV.NVVPMAD.STATE.FL.US
SOUTH FLORIDA WATER MANAGEMENT DISTRICT
P.O. BOX 24680
33C' GUN CLUS ROAD
tVEST PALM BEACH. FL 3 4'c-458'J
PHONE: , 561, 686-3800
VA'VW.SFV'VMD.GOV
SUWANNEE RIVER WATER MANAGEMENT DISTRICT
9225 CR 49
LIVE OAK. FL 32060
PHONE : 556: 362-10;u1 cr;800, 22o s35e Flonda c '-
bVIVbV.MYSUi+w'ANNEERI`dEP..COPih
Comments:
�+
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Of
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Genera! She Mao of Provased Well Location -. .
0�
N69'03'19"E -140.00'
k33� k 6 �YOOD PRIVA_ C-E
2. 67 2. 86 ,3 6, 7 Jr Q
POOR CONDITION
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o
O
3 69
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cn to
0 c
36.64'
I
, r 25. 0'
/ RS 0R eD
c
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/ Fsipe cg
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6 N o (A4—
_
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<�
44.81'
38.06'�
n
PROPOSED
WELL
acts
o
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I I
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in p
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o�c
41
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8g
6,413'11 "E - 140.00'
i•:@' .'.`.5:: 'd':.5 _-,. i3'':ti:;:;�iri: ....-
..,_._. =8S `.. 31' c'E"=.. .. ... .. ... _.. 022:• _ . _ .- .a_ f=< ., - -_ ._. n.:s: _.
_ .... -. �. .
Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved.
Site Address: OAK DR
Sec/Town/Range: 36134SI40E
Parcel ID: 1436-601-0055-000-7
Jurisdiction: Saint Lucie County
Ownership
Kevin James Murphy
Terri Michele Murphy
32 Harbour Isle DrW Unit 301
Fort Pierce. FL 34949
Property identification
Use Type: 0000
Account �: 12157
Map ID: 1436N
Zoning: RS-4 Count
Legal Description
FORT PIERCE SHORES -UNIT I - BLK 3 LOTS 6 AND 7 (0.44 AC - 18.940
SF)
Current Values
Just/Market Value: S80.200
Assessed Value: 555.781
Exemptions: so
Taxable Value: $55.781
Property taxes are subject to change upon
change of ownership.
• Past taxes are not a reliable projection of future taxes.
• The sale of a property ivill prompt the removal of all
exemptions, assessment caps, and special classifications -
Taxes for this parcel: SLC Tax Collector's Office
Download TRIM for this parcel: Download PDF
Total Areas
Finished,Under Air (SF):
Gross Sketched Area (SF): 0
Land Size (acres): 0.43
Land Size (SF): 19.940
Building Design Wind Speed
Occupanc-
y Category 1 11 in & IV
Speed 140- 160 170
All information is believed to be correct at this time, but is subject to change and is provided without any warranty.
Cc, Copyright 2020 Saint Lucie County Property Appraiser. All rights reserved.
1
3. St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
HEALTH
PAYING ON: #: 56-SF-2210651 BILL Doc #.56-BID-5120779 CONSTRUCTION APPLICATION #: AP1605278
RECEIVED FROM: ASHTON SEPTIC TANKS, INC. AMOUNT PAID: $ 660.00
PAYMENT FORM: CHECK 12979 PAYMENT DATE: 12/07/2020
MAIL TO: Ron Raymond
FACILITY NAME:
PROPERTY LOCATION:
Oak Dr
Fort Pierce, FL 34949
Lot: 6 & 7 Block: 3
Property ID: 1436-601-0055-000-7
EXPLANATION or DESCRIPTION:
128 - OSTDS Construction System Inspection Research Fee
-1 - Surcharge (All)
-1 - OSTDS New Permit Surcharge
-1 - OSTDS Construction Application and Plan Review, New
123 - OSTDS Construction Site Evaluation
126 - OSTDS Construction Permit (New or Mod, Amendment)
127 - OSTDS Construction System Inspection
133 - OSTDS Construction Reinspection
-1 - Well Construction
RECEIVED BY: AdamsC
Note: 59-31281
QUANTITY FEE
1 $
5.00
1 $
45.00
1 $
100.00
1 $
100.00
1 $
115.00
1 $
55.00
1 $
75.00
1 $
50.00
1 $
115.00
AUDIT CONTROL NO. 56-PID-4822898