HomeMy WebLinkAboutWater Well Permits"D- Q) c --
Mission:
To protect, promote & improve the health
of all people in Florida through integrated
state, county & community efforts.
r10u t
HFA11H
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(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-WELLS(a-)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 Milner Drive - Port St Lucie, FL 34983 . Public Health Accreditation Board
PHONE: 772/462-3800 - FAX: 772871-5360
StLucieCountyHealth.com
STATE OF FLORIDA PLl.:MIT- PIPLICACION ` O CT-4:6TRUCT, r �1 Q l's
REPAIR, MODIFY, OR ABANDON A WELL Ponnil No.-.-., .. 59-31313
i�p'111E.Sp'��,
Southwest PiEASEFILI OUrAL-, APPt.ICAnl.rf:0OS Florida lhlique IU--•----_.^ -
s°jA`' I_: Northwest ('Donotios Required Fields Where Applicable) Poona 50pulatian:i Required (Soo Altadwd)
A�SI.Jos Rlvarnln wl110r mull I.pntral.hx 1$ re� / 1tit(110 lur cum Uolln'-.__._...__ .•_...__-.._.--_._.-_ _____ .____..oridii' > +rr: + y this (am and lonvaedGl llw molt a 1lication roint+ 1 y p pl fit-.i24 Quad Nn.ee River UJI)DWlifte doloyaled eutllonly when/ appllcncto.
°u dLl DEPCUPJWUP Appllentlon No.
- IJ Date ated Authorit 1 If A lit xbhs
g' y ( PP ) .•------------
.� l �a•-
Logal Nmmn if Cc
2._
3. J�fi lam'" 1
Farce: II No. (PIW o
4. C�
.section o Land Groot
hfr Addras l
7 J •� Y - Slaty `ZIP "ItlephgneNumbcar
Name r'NAimhar,City
IS::y1(Circle n0) \ I Il , !l • �L1o; Block Unit
/i1�T11p °Ra1�ge 'G'C Subdivision Check if 62 5 4. Yes �J'Ju
I J• -_�� .L...1.1:._t� - ...._Ci��'1L.___u'.�l L+..ISr�•�! � 'IJ � i�
'Water Well Contractor 'License Number 'Telephone N inter, E-rnail Address `' 1 t
1 TJ� I
If
6. -- - -- -- ... -.. _ . �.:. S'L}' ► w)t Li�-- - - -=-_ _ �� 1, L ! 1
`Water Well Contractor's Address City State ZIP
7. *Typo or Work: Conatruolion ,Rnl»ir „ A1odi/ication , , Abandonment
8. 'Number Qf Pfep096d WAIIS _ ' 'Rnallon rw Rrpa7,". MnulnC..ilkln, ar'A6n-- -' '• '- •
9. 'Specify Intended Use(s) of Welll(s): - D Im e
�D
-,-- -Domestic Landscape Irritation --Agricultural Irrigation _ Silo Invastigation
Bollled Watel Supply Recreation Area Irrigation 1_ivestnck 10onlloring
I _Public Water Supply (Limited U%3WOOH) Nursery Irrtation Test
Public Water Supply (Community or Non-Con)munily/DL'•P) ' Commercial/Industrial Earth -Coupled Geothermal F E B 1 B 2i �2 1 ►;
Golf Courco Irrigation HVAC Supply
Class l injection HVAC Rolum N
Class V Injection: -._Recharge-_- CommerciallIndut trial Onposal Aquifer Storage ant) Recovery •, • .Drainagg•e
RemediLition; ___ Recovery _.___,Air Sparge Other (uc.cr•Ix,> F OH in St Lucie Cou
_... _. (ilflor (par..um),_._.......-_ _.......- . p . ._ . _ .. tNulu Not n•i Iy1jVS�Mrl.::�1(p Ijun(Illl-I I.} n rGk'm I]1,n111nII.0 J1 l-dy)
10,'Distaneo from Septic $uste+m if s200 R.� 11. Facility Description- _- '?�__� - y _ 12. Estimated Start Dat _--„-;
13,'f_stirrla1erJ Well Depth -,.A _.'_fl. 'Eslirnated Casing Depth 7 ft. Primary Casing Diamulc;r . 4 � . in. Open Hole From ^ To It.
14. Estimated Screen Interval: From /)To - c-11.
15.'Prirnary Casing Material: _Black Steel _--,-Ualvanizlia i\• ('VC SlainiCSsS(enl
16. Secondary Casing: _-Telescope Casing Liner Surface Casing Diamotor in. -- --
17. Secondary Casing Material: Blacl( Steel _-- Galvai:i'rvtt _-_ PVC Sttrnless SIeEI Other
IVIvlathod of Construction, Repair, or Abandonment: ------- Auger _ Cable Too! --._-,JP.ttl+tl �Rotary
---_ Combinallon (Two or More Methods) ..... Hand Driven (Woll Point, Sand Point) Hydraulic Point (Direct Push)
__...-Horizontal Drilling ... ...Plugged by Approved Method Otherloeoauy),-._.•, ,,, ,,-.,•. .
19. Proposed CZroulirg rvat for the Primary, Secondary, and Additional Casing:
From 1� To i I Seal Material (_ __•_ Bentonile_y Nadi Cement Other
From To.-, Seal Material ( Bentcnile, . Neat Comont , ,.. Other -
From___ ---To. _ __•-- - Seal Material (-.---Bantonile__.,_,• Naal Cement. Other
-- I
From TO Soal Material L_Bellloltile--Neat Camrtnl__.--UII)er_• � -••-- )
20. Indicate total number of oxistin.9 wells on site,_- _ List number ofexisung unused wells on site _
21.'Is this well or any existing well or water withdrawal on the owner's contiguous properly covered under a Consul itipliveNVater Use Permil (CUPIWUP)
or CUPIMP Application? Yes _�r<,LNo If yes, complete Iito following; CUP/WUP No.__- _ _ District Well ID No. ,-_- -
22. Lalitudo -• • Longitude
23. Data Obtained From: M-GPS Map Survey Dtilurn _- _ NAD 27 ___NAD 83 ___WGS 84
I - l,y fn,1•ty Intl 1..Y fiV V1'I,•-D. N.. npyk..0... 1.'n I111.w. 01. r41..1., Jy1M1✓ ,I., Dyy .�.�I.., ,1,M ✓1,1 ., •.n 1.' ", M.J I.yn llV M1.wl. f 1✓ VV1 Innllnny, awl Ve. ✓ itr,ritiWa, lu N10,10 oftow. 0'n K111 04. •11- 01 n,:
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cGND WWAI. 111•rU•OrU•1-nl`r Np1 NI Nf0'Inp'1µl pOri•h1U W UtN ,yruKri•yl l0 a.:� .rpl� pvl n•✓t lw..I dll wn YY O�It.N rV I1.V V+n,Y, 11id IM1y .I,iy.nln+Vf, I•.pV_Ip{I.p O(,gf 01n 114 DWI 11il nWe W p10,TVn01 M1l IIlm.
w..".40tV,VI i1n 0VWrlwlu,A, alJl4 u1 IJWI(IywuwlV4U•. •t ✓J{•:471lV lJU1':✓Iy ,,. M,:: rYww.I.0::y0 JI lil.iwi pin.•• de.lcr,un:V1.{y IV' 1j Dwrd,ld Vl IIn4Y+Jle Ktk!r.ylWll AJ✓al!y Ol:y�L
W.,fAy.w. IYOyn N IIY (.-ici V u w ait tlnyii °Air uu,W6j,,al el V. U11:.Wf,D(/. 11.:.1✓. 11°1J11.•4LWl 11 I. 1WU aW Va
✓L,..WIi�Ilw,11t.1.IW,.:�,1Lj1.11J DYf•,lI1. Vf W0 yNn�1 Wr•NI,I W., wll.11,y,Jr UUNt�lv.1. I✓I�O W.'•W Wf., oow. inL>Kxaw ttOtM110.'✓V1WN:WDgfl'JA Ay V.II DI.Inul
'SigKu, of Conlrador 'Lu orso No. t 'Signature of tDWNerprI19 �✓ `-4 - 'Dale
Approval Granted By
Issue Dale f� z (_ Expiration Date � I ky Hydrologist Approval
-'-•---'----- - -' -
Fan Roceiverl y- ' --- - -- -- - - - Racegn No. _ _ Cheek Na.
HIS PERMIT IS NUT VALID UNTIL PROPERy SIGNED BY AN ACl IinRiZED OFFICFR OR RL'PR=SENTl1'`IVE OF TI lE MAC OR DELEGATED AUTb10RITY THF.
PERNIaT SHAY t BE AVAILABLE AT -HE WELL SITE DURING At I ()r)NSTRI)CTiON. RFPAIii, t,d()DlFIC:A71e)N. r)ti ABANDON"AENT AC71VITIES.
d
IS
DF,P Form: 62-532.900:I) lnrorpormcd In. 52 532 dent• ). F.A.C. FtW:mr r:-dn' Or oor 1, 2U' 0 ?;rgr. • r;! ::
0 2 0 s e t i
_ St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
HEALTH
PAYING ON: #: BILL Doc#:56-BID-5126038
RECEIVED FROM: American Drillinq AMOUNT PAID: $ 115.00
PAYMENT FORM: CREDIT CARD 092523 PAYMENT DATE: 12/14/2020
MAIL TO: American Drilling
Okeechobee FL 34974
FACILITY NAME: American Drilling
PROPERTY LOCATION:
Okeechobee FL 34974
Lot:
Property ID: _
-1 - Well Construction
EXPLANATION or DESCRIPTION:
RECEIVED BY: WhighamJL
Note: 59=.31313 1401 Lone Pine Rd
Block:
QUANTITY FEE
1 $ 115.00
AUDIT CONTROL NO. 56-PID-4828492
Propeity Card
Page 1 of 1
Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved.
Property Identification
Site Address: 1401 Lone Parcel ID: 3409-505-0023- Account #: 166423 Sec/Town/Range:
Pine DR 000-1 09/36S/40E
Map ID: 34/09N Zoning: Planned Un Use Type: 0000 Jurisdiction: Saint Lucie
County
Ownership Legal Description
Kelley R Cornett LONE PINE SUBDIVISION (PB 51-21) LOT 18 (OR 4034-
Caleb Bryant Bowen Cornett 111)
1196 Country Gardens LN
Fort Pierce, FL 34982-3327
Current Values Historical Values 3-year
Just/Market:
$41,800 Assessed:
$36,300 Year Just/Market Assessed
Exemptions
Taxable
Exemptions:
$0 Taxable:
$36,300 2020 $41,800 $36,300
$0
$36,300
2019 $36,000 $33,000
$0
$33,000
2018 $30,000 $30,000
$0
$30,000
Sale History
Date
Book/Page
Sale Code Deed Grantor
Price
08-11-2017
4034 / 0111
0001 WD Ryley Winston A
$14,000
06-22-2012
3407 / 0597
0001 WD Oceans Four Development Corp
$13,800
05-14-2003
1714 / 2681
XX00 WD Taylor Eleanor R
$240,000
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:
Type
Total Areas
Finished/Under Air
0
(SF):
Gross Sketched Area
0
(SF):
Land Size (acres):
0.36
Land Size (SF):
15,782
Total Building Count:
1
Special Features and Yard Items
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.
G Copyright 2020 Saint Lucie County Property Appraiser. All rights reserved.
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