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STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT, SF M 22`0^1 v�0
REPAIR, MODIFY, OR ABANDON A WELL_ 59-31435
! ermit No.
_ —
an 7 `i f� 7J NorhavesSouthwest PLEASE FILL OUTALLAPPUCABLe FIELDS Florida Unique ID -
0 St. Johns
('Denotes Required Fields Where Applicable)1--P7
Pomtit SlIpulatlons Required (See Attached)
U St. Johns River
w,- 8outhFlorida The wdlartwrtconuwarkm3
po, &PP tar cn to m r>b
+ ; O Suwannee River tdats roan arrd lkWled n @re Dome? v appgian M tee 2-524 Ouod No. Delineation No.
C"I DEP pjsmprtere deMgaredatrthaity wltfao appriwC:a.
)tZS ,r
U Delegated Authority (If Applicable) CUPANUPApplication No.
ddr
2. 7er, Legal Name 11 Corpora io L s--'s ,,-"""� - t" �U^
1�1�2
ire 6 �Yl' State 'T(lit P t� ,taeleN phone umber
Well Loaati n . Road Noma oma or Nu r�i Sor, City
Parcel ID No. (PIN) or Alternate i<�y ( Irrle One)
4. (�2- r 0 S_L Lot Block Unit
�u C i �---
iun ar and Grant Township `Range 'Count ---
5. Subdivision Check if 62-524: ^ Yes
1A No
'Water Well Contractor •License Nurnber Cells ddr
((� /t elephon umber E-mail Address
6. � [ )�) � itA u.l ,u_Vl n�j s ih J! /'� •-'� t. r�_ _
7- "Type of Mork: -YConstructio -_Repair ,_____Modification Abandonment elate ZIP
8."NumberoiProposed Watts ncaaanrartrep+'v, hMaxricutcn,crAbanaonrnant
r9. 'S city Intenders Use(s) of WeFI a
orneslic Landscape it �gatian _Agricultural Irrigation Site Investigation A O l.9 dJ w,
�Bottled Water Supply 'Recreatiea Irrigation __._:Livestock �
on Ar
Monitoring
_„Public Water Supply (Limited UselDOH) --
Nursery Irrigation Test
g
—Public Water Supply (Community or Non-Community/DEP) -- COmmerciaUindustrial `Earth-Couplad Geothermal
Class i Injection _-Golf Course Irrigation _HVAC Supply j F �
HVAC Return '' -
Class V Injection; _Recharge -__--_Commerciallindustrial Disposal Aquifer Storage and Recovery _Drainage
Remediation: Recovery _AirSparge --__Other (aoxiw�g
)_. _---- �CI�II 1tsD�JicilQ)i�
Other (ot ecnba) Cot
(Nola: Nal 019 —. --` types dwEeIS Ixn petro{ttcd ay a giivn pennilbng aumoa
10.'Distance from Septic System if s200 ft,' } -r{�' 11. Facility Description 1
12. EsUrnated Start Date
13.'Estimated Well Depth I(K> ft *Estimated Casing Depth due' ft. 'Primary Casing Diameter frt. Open Hole: From To ft.
14. Estimated Screen interval: From,-�U To LO0, ft. -
IS.'Primary Casing Material: Black Steel Galvanized ,. 1� PVC '
-- — Stainless Steel
Not Cased Other.
16. Secondary Casing: Telescope Casing _
17, Secondary Casing Material; Black Steel
16.'Melhod of Construction, Repair, orAbandonrnenC
Combination (Two or More Methods)
Horizontal Drilling _ Plugged byAp'
19. Proposed Grouting Interval for the Primary, Seco�i
From 4To_ -Seal Material _Bet
From To Seal Material (Bar
From _ -'ro� Seal Material
From'�_To_-___ Seal Material („ `Bar
20. Indicate total number of existing wells on site
Liner Surface Casing Diameter In.
_Galvanized PVC ____Stainless Steel
��� �Other
Auger Cable Tool Jetted ':.Y";'Rotary %. Sonic
Hand Driven (Well Point, Send Point) Hydraulic Pant (Dtroct Push)
ied Method Other io smba)
ry, and Additional Casing:
nile _Neat Cement____,_Other )
nite— Neat Cement Other )
vita Neat Cement Other )
nite -Hoot Cement Other ? /
List number of existing unused wells on to /
21.'Is this well ar any existing well orwatorwithdrawai on the owner's contiguous propertycovered undera Consumplive/Water Use Permit (CUPANUP)
or CUP/WLIPApplication? Yes' o of yes, complete the following: CUPANUP No. District Well ID No.
22. Latitude Longitude
23. Data Obtained Frcm: GPS Map Survey
t t,inby mVr rr.,a t..,t.¢mp.4 ®a b+o naStGYo rlesmtna :tf, Rs'.da Mm.� ,Lrtrn C.rrm. ma y+rt a .rn
.1E t9miY e! YCUGYf IW:'wryb aL t if IwN.nt, eU. tVea m v4 tY?iinap 4 "� to 2rrmut�'+s'n4nt O<Mid
oonttnntgr,. 1 `+tl�r urcH Cwf n3 tn:�rra�m rau.�doC a+aai „rt•:ursn w om t. a!ut ctut t ..f uds-�
nn.AtWd / cpyrom+ uAI OOHS kdtM, 0 de pe teem+yoraet, n of I f b.,pit ixt I t u , q Narctn A Ott
ecn4Yn2ary fK't+l +e o wrhM w tlap AMt mtryetue+ct Stu tCnLiirtian-,ipA:r, mw�ttatron, u
DWAaM11NM1? -0onroiv ine jAit, v ten r.rmt eioraseq. ,„r+a'!x"H u;uva tuj,Y.
'Unyee No.
Approval Giantess By
Daturn: NAD27 NAD 83 WGS 84
I tvVY 4-0 inn MO -- of Cie tHccalr. trot am Mf :abn pctidad's or We .Wow I am--Nmr
eaeacrsb+Etus undW balm SM, F=Aea aWub; to M qt M W VMMy BLWt ?.s mot y I."tt+N I mn
fia-Q-t for No 0A .Pitt the lMMMWL nQ+c dntt IS 6cCiTattl, rd" I t,T* iniolmo Vm mRpj of Net
to"W- &W v V. —*U Hsm MP*—4ftm-, W "Wwaw,.4 NIIotA by at. a-agntY aW+ti
Fee Received �--�� [ �' Receipt No.
THIS PERMIT IS NOT VALID UNTIL PROPERLY SIGNED BY AN AUTHORIZED OFFICER OR R
PERMIT SHALL HE AVAILABLE AT THE WELL SITE DURING ALL CONSTRUCTION, RIEPAIR, h
DEP Form:62-532.900(1) incorporated in 62531400(1). F.A C. Eflaclivo Oafo; Odober7, 2010
Expiration Dale .4?G I K Hydrologist Approval
—r— Ntae
_ Chock No.
/E OF THE WMD OR OELEGATED AUTHORITY, THE
OR ABANDONMENT ACTIVITIES.
Page 1 of 2
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SOUTHWEST FLORIDA WATER MANAGEMENT DISTRICT
2379 BROAD STREET, BROOKSVILLE, OL 34604-6899
PHONE: (352) 796-7211 or (800) 423-1476
WWW.SWFWMD.STATE.FL.US
ST. JOHNS RIVER WATER MANAGEMENT DISTRICT
4049 REID STREET, PALATKA, FL 32178;1429
PHONE: (386) 3294500
WWW.SJI2WMD.COM
NORTHWEST FLORIDA WATER MANAGEMENT DISTRICT
152 WATER MANAGEMENT DR., HAVANA, FL 323334712
(U.S. Highway 90, 10 miles west of Tallahassee)
PHONE: (850) 539-5999
WWW.NWFWMD.STATE.FL.US
Comments:
1
Permit No. 5c( - 31 g s S
SOUTH FLORIDA WATER MANAGEMENT DISTRICT
P.O. BOX 24680
3301 GUN CLUB ROAD
WEST PALM BEACH, FL334164680
PHONE: (561) 686-8800
WWW.SFWMD.GOV
SUWANNEE RIVER WATER MANAGEMENT DISTRICT
9225 CR 49
LIVE OAK, FL 32060
PHONE: (386) 362-1001 or (800) 226-1066 (Florida only)
WArW.MYSUWANNEERIVER.COM
'General Site Map of Proposed Well Location
L '1�
I— —
Identify M _own roads and landmarks. Give d{stnnces from all mforence points or structures, sopdc
DEP roan 62-532.000(1) fncorporuted In 62-532.400(1), F.A.C. Effective Dalo: October 7, 2010 -
and contamination
m
P1390 2 of 2
Page 4 of 6
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Page 5 of 6
Michelle Franklin, CFA --I Saint Lucie County Property Appraiser -- All rights reserved.
Property Identification
Site Address: 960 GOPHER Parcel ID: 3404-305-0025- Account #: 39943 Seoirown/Range: 04/36S/40E
RIDGE RD 000-2 Map ID: 34/04S Zoning: RS-3 - Cou
Use Type: 0100 Jurisdiction: Saint Lucie
County
Ownership Legal Description
Rodolf'o Vega J A SMITFI'S S/D LOTS 25, 29, 30 AND 31 (0.62 AC)
Carmen Hemandex
904 Osceola DR
Fort Pierce, Fl, 34952
Current Values
Historical Values 3-year
JustAMarkot:
S40,600 Assessed:
S40,600 Year Just/Market Assessed
Exemptions
Taxable
Exemptions:
SO Taxable:
$40,600 2020 S40,600 $40,600
SO
S40,600
2019 S40,600 S40,600
SO
S40,600
2018 S49,000 S34,496
SO
S34,496
Sale History
Date
Book/Page
Sale Code Deed Grantor
Price
07-27-2013
4162 / 0957
0111 SP Becker Keith Joseph
SIM
07-20-2018
4160 / 2499
0001 WD Davis Elicte Costa Lima
S25,000
07-20-20115
4160 / 2495
0111 QC Davis Elicte Costa Lima
$100
Primary Building Information
Finished Area of this building: 2,455 SF
Gross Sketched Area: 2,605 SF
Exterior Data
View:
Roof Cover: Roof Structure:
Building'rype: HD -
Year Built: 1955
Frame:
Grade: D-
Effective Year: 1955
Primary Wall: Cone
Block Story Height:
1 Story No. Units: 1
Secondary Wall:
Interior Data
Bedrooms: 4
A/C %:
100% Electric: MAXIMUM
Primary Int Wall:
Full Baths: 2
Heated 0/4:' 100% Hcat Type:
Avg Hgt/Floor: 0
Half Baths: 0
Sprinkled W N/A% Heat Fuel:
Primary Floors:
Total Areas
Finished/Under Air
2,485
(SF):
Gross Sketched Area
2,605
(SF):
Land Size (acres):
0.62
Land Size (SF):
27,007.2
'total Building Count:
I
Special Features and Yard Items
Type Qty Units Year Bit
Driv-Concret 1 720 1999
All inforntntion is believed to be correct at this time, but is subject to change and is provided without any warranty,
0 Copyrighv2021 Saint Lucie County Property Appraiser. All rights reserved.
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