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HomeMy WebLinkAboutFDEP Permit®Li _01 K4 Southeast District Office 3301 Gun Club Road, MSC 7210-1 West Palm Beach, FL 33406 561-681-6600 Project Name: Maurice Splain III Permittee/Authorized Entity: Maurice Splain III 123 Cypress Tree. Royal Palm Beach, FL. 33411 Email: s537runner.ssQp-mail.com Authorized Agent: DLS Environmental Services, Inc. c/o Danna Small Email: Danna(a7DLSenvironrnentaiservices.com Environmental Resource Permit - Granted State-owned Submerged Lands Authorization — Granted U.S. Army Corps of Engineers Authorization — Separate Corps Authorization Required Permit No.: 56-219122-002-EI Ron IDesantls Govemor Jeanette Kufiez Lt Govemor Noah Valensteln Secretary Permit Issuance Date: December 11, 2020 Permit Construction Phase Expiration Date: December 11, 2025 ®� Consolidated Environmental Resource Permit and State-owned Submerged Lands Authorization Permit No.: 56-219122-002-EI PROJECT LOCATION The activities authorized by this Permit and state-owned submerged lands authorization are located within Indian River Lagoon, within the Jensen Beach to Jupiter inlet Aquatic Preserve, Outstanding Florida Waters, Class III Waters, adjacent to the single-family residence at 9895 S. Indian River Dr. Ft. Pierce, (Section 29, Township 36 South, Range 41 East), in Indian River County (Latitude N 27' 19' 10.31", Longitude W -80° 15' 52.41"). PROJECT DESCRIPTION This permit authorizes the construction of a 1,000+/- square foot dock with an associated slip with 3 mooring piles. This permit authorizes 1,000 ftz of work in surface waters. Submerged resources are located within the project boundaries. To offset unavoidable impacts that will occur from these authorized activities, the permittee has implemented the following design modifications to eliminate direct impacts to these resources. The access walkway will be 5 feet above MHWL and 4 feet wide with %Z-inch board spacing for the landward 150 linear feet. For the waterward 72 linear feet of access the walkway will be constructed of grated decking with 43% open space, 4 feet wide and elevated 5 feet above MHWL. The 8-foot by 14-foot terminal platform will be constructed of grated decking with 43% open space, elevated 5 feet above MHWI.. Therefore, mitigation is not required. AUTHORIZATIONS Environmental Resource Permit The Department has determined that the activity qualifies for an Environmental Resource Pen -nit. Therefore, the Environmental Resource Permit is hereby granted, pursuant to Part IV of Chapter 373, Florida Statutes (F.S.), and Chapter 62-330, Florida Administrative Code (F.A.C.). Sovereignty Submerged Lands Authorization The activity is located on sovereignty submerged lands owned by the State of Florida. It therefore also requires authorization from the Board of Trustees of the Internal Improvement Trust Fund (Board of Trustees), pursuant to Article X, Section 1 l of the Florida Constitution, and Section 253.77, F.S., and Chapter 258, F.S. As staff to the Board of Trustees under Sections 253.002, F.S., the Department has determined that the activity qualifies for and requires a Letter of Consent, as long as the work performed is located within the boundaries as described and is consistent with the terms and conditions herein. During the term of this Letter of Consent you shall maintain satisfactory evidence of sufficient upland interest as required by paragraph 18-21.004(3)(b), Florida Administrative Code. If such interest is terminated or the Board of Trustees determines that such interest did not exist on the date of issuance of this Letter of Consent, this Letter of Consent may be terminated by the Board of Trustees at its sole option. If the Board of Trustees terminates this Letter of Consent, you agree not to assert a claim or defense against the Board of Trustees arising out of this Letter of Consent. Project Name: Maurice Splain DT Permit No.: 56-219122-002-El Page 2 of 14 Federal Authorization Your proposed activity as outlined on your application and attached drawings does not qualify for Federal authorization pursuant to the State Programmatic General Permit and a SEPARATE permit or authorization shall be required from the Corps. You must apply separately to the Corps using their APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT, ENG FORM 4345, or alternative as allowed by their regulations. More information on Corps permitting may be found online in the Jacksonville District Regulatory Division Source Book at: https://www.sai.usace.armv.mil/Missions/Regulatory/Source-Book. Authority for review - an agreement with the USACOE entitled "Coordination Agreement Between the U. S. Army Corps of Engineers (Jacksonville District) and the Florida Department of Environmental Protection (or Duly Authorized Designee), State Programmatic General Permit", Section 10 of the Rivers and Harbor Act of 1899, and Section 404 of the Clean Water Act. Coastal Zone Management Issuance of this authorization also constitutes a finding of consistency with Florida's Coastal Zone Management Program, as required by Section 307 of the Coastal Zone Management Act. Water Quality Certification This permit also constitutes a water quality certification under Section 401 of the Clean Water Act, 33 U.S.C. 1341. Other Authorizations You are advised that authorizations or permits for this activity may be required by other federal, state, regional, or local entities including but not limited to local governments or municipalities. This permit does not relieve you from the requirements to obtain all other required permits or authorizations. The activity described may be conducted only in accordance with the terms, conditions and attachments contained in this document. _ Issuance and granting of the permit and authorizations herein do not infer, nor guarantee, nor imply that future permits, authorizations, or modifications will be granted by the Department. PERMIT and SOVEREIGNTY SUBMERGED LANDS CONDTIONS The activities described must be conducted in accordance with: • The Specific Conditions • The General Conditions • The Special Consent Conditions • The General Conditions for Sovereignty Submerged Lands Authorization • The limits, conditions and locations of work shown in the attached drawings • The term limits of this authorization You are advised to read and understand these conditions and drawings prior to beginning the authorized activities, and to ensure thi work is conducted in conformance with all the terms, conditions, and drawings herein. If you are using a contractor, the contractor also should read and understand these conditions and drawings prior to beginning any activity. Failure to comply with Project Name: Maurice Splain III Permit No.: 56-219122-002-EI Page 3 of 14 these conditions, including any mitigation requirements, shall be grounds for the Department to revoke the permit and authorization and to take appropriate enforcement action. Operation of the facility is not authorized except when determined to be in conformance with all applicable rules and this permit and sovereignty submerged lands authorization, as described. SPECIFIC CONDITIONS- PROJECT FORMS & ATTACHMENTS (1) The attached project drawings (sheets 1 through 4); the Standard Manatee Conditions for In - Water Work, 2011, and DEP forms 62-330.310(1); 62-330.310(2), 62-330.310(3); 62-330.340(1); and 62-330.350(1), which may be downloaded at hq://www.dgp.state.fl.us/i#ater/wetlands/erp/forms.htm become part of this permit. If the permittee does not have access to the Internet, please contact the Department at (561) 681-6600 to request the aforementioned forms and/or document(s). SPECIFIC CONDITIONS - PRIOR TO CONSTRUCTION (2) After selection of the contractor to perform the authorized activities and prior to the initiation of any work authorized by this permit, the permittee (or authorized agent) and the contractor shall attend a pre -construction conference with a representative of the Department. It shall be the responsibility of the permittee to contact the Department's Compliance Assistance Program, by email SED Compliance@FloridaDEP.gov, or by phone (561) 681-6600, to schedule the pre -construction conference. (3) Prior to the initiation of any work authorized by this permit, floating turbidity curtains with weighted skirts that extend to within one foot of the bottom shall be placed around the project site and shall be maintained and remain in place for the duration of the project construction to ensure that turbid discharges do not occur outside the boundaries of the floating turbidity screens. Additionally, staked erosion control devices shall be placed around the upland project area and any upland staging areas. All submerged resources, and surface waters outside the specific limits of construction authorized by this permit shall be protected from erosion, siltation, sedimentation, and/or scouring. Staked erosion control devices shall also be maintained and shall remain in place for the duration of the project construction to ensure that turbid discharges into wetlands or surface waters do not occur. The permittee shall be responsible for ensuring that turbidity control devices are inspected daily and maintained in good working order during all phases of construction authorized by this permit until all areas that were disturbed during construction are sufficiently stabilized to prevent turbid discharges. SPECIFIC CONDITIONS — CONSTRUCTION ACTIVITIES (4) Except for piling installation, no dredging or filling of submerged grass beds or live bottom communities is authorized by this permit. _ (5) Storage or stockpiling of tools and materials (i.e., lumber, pilings, debris) within wetlands, along the shoreline, within the littoral zone, or elsewhere within wetlands or other surface waters is prohibited. This includes floating of pilings in surface waters. All vegetative material and debris shall be removed to a self-contained upland disposal area with no stockpiling of debris within wetland areas. Project Name: Maurice Splain III Permit No.: 56-219122-002 EI Page 4 of 14 (6) A floating turbidity curtain shall be installed around the construction area and will remain in place until pilings have been installed and turbidity levels within the work area have returned to background levels prior to construction of the dock. () Watercraft associated with the construction of the permitted structure shall operate within waters of sufficient depth to preclude bottom scouring, prop dredging or damage to submerged bottom or submerged resources. During all construction activities, there shall be a minimum of 1- foot clearance between the draft of the construction vessel/barge and the top of any submerged resources or submerged bottom. SPECIFIC CONDITIONS — MONITORING/REPORTING REQUIREMENTS (8) Turbidity levels outside the construction area shall not exceed 0 NTU's above background levels. The following measures shall be taken immediately by the permittee whenever turbidity levels within waters of the State surrounding the project site exceed 0 NTUs above background: a. Notify the Department at (561) 681-6600 at the time the violation is first detected. b. Immediately cease all work contributing to the water quality violation. c. Stabilize all exposed soils contributing to the violation. Modify the work procedures that were responsible for the violation, install more turbidity containment devices, and repair any non- functional turbidity containment devices. d. Perform turbidity monitoring. e. Resume construction activities once turbidity levels outside turbidity curtains fall below 29 NTUs. (9) Water turbidity levels shall be monitored if a turbidity plume is observed outside the limits of the required turbidity control devices. Samples shall be taken every four hours; one foot above the bottom, mid -depth, and one -foot below the surface at monitoring stations located as follows: a. Approximately 100 feet up current of the work sites and clearly outside the influence of construction activities. (This shall serve as the natural background sample against which other turbidity readings shall be compared) b. Directly outside the turbidity curtains surrounding the work sites and within the densest portion of any visible turbidity plume. (This sample shall serve as the compliance sample.) (10) During non. -compliance events activities, the permittee or permittee's contractor shall collect the following turbidity monitoring data, at the frequency and water depths directed by the Specific Condition above: a. Date and time of sampling event b. Turbidity sampling results (background NTUs, compliance NTUs, and the difference between them) c. Description of data collection methods d. An aerial map indicating the sampling locations e. Depth of sample(s) f. Weather conditions at times of sampling g. Tidal stage and direction of flow Project Name: Maurice Splain M Permit No.: 56-219122-002-EI Page 5 of 14 Data shall be collected in a turbidity log and shall include a statement by the individual responsible for implementation of the sampling program attesting to the authenticity, precision, limits of detection, and accuracy of the data. The turbidity log shall be scanned and sent on a weekly basis to the Department's Compliance Assistance Program by email at SED Compliance(@—floridadep.gov. The subject line of the email shall include the project name, permit number, and the title "Turbidity Monitoring Reports." SPECIFIC CONDITIONS — OPERATING CONDITIONS (11) Vessels utilizing this structure shall maintain a minimum of one -foot clearance between the deepest draft of the vessel with the engine in the down position and the submerged bottom so as to preclude bottom scouring or prop dredging. SPECIFIC CONDITIONS — MANATEE CONDITIONS (12) The permittee shall comply with the standard manatee protection construction conditions listed in the attached "2011 Standard Manatee Conditions for In -Water Work". SPECIFIC CONDITIONS —LISTED SPECIES (13) This permit does not authorize the permittee to cause any adverse impact to or "take" of state listed species and other regulated species of fish and wildlife. Compliance with state laws regulating the take of fish and wildlife is the responsibility of the owner or applicant associated with this project. Please refer to Chapter 68A-27 of the Florida Administrative Code for definitions of "take" and a list of fish and wildlife species. If listed species are observed onsite, FWC staff are available to provide decision support information or assist in obtaining the appropriate FWC permits. Most marine endangered and threatened species are statutorily protected and a "take" permit cannot be issued. Requests for further information or review can be sent to FWCConservationPlanninaServices@MyFWC.com. GENERAL CONDITIONS FOR INDIVIDUAL PERNIITS The following general conditions are binding on all individual permits issued under chapter 62-330, F.A.C., except where the conditions are not applicable to the, authorized activity, or where the conditions must be modified to accommodate project -specific conditions. (1) All activities shall be implemented following the plans, specifications and performance criteria approved by this permit. Any deviations must be authorized in a, permit modification in accordance with Rule 62-330.315, F.A.C. Any deviations that are not so authorized may subject the permittee to enforcement action and revocation of the permit under Chapter 373, F.S. (2) A complete copy of this permit shall be kept at the work site of the permitted activity during the construction phase, and shall be available for review at the work site upon request by the Agency staff. The permittee shall require the contractor to review the complete permit prior to beginning construction. (3) Activities shall be conducted in a manner that does not cause or contribute to violations of state water quality standards. Performance -based erosion and sediment control best management practices shall be installed immediately prior to, and be maintained during and after construction as needed, to prevent adverse impacts to the water resources and adjacent lands. Such practices shall be Project Name: Maurice Splain III Permit No.: 56-219122-002-EI Page 6 of 14 in accordance with the State of Florida,Erosion and Sediment Control Designer and Reviewer Manual (Florida Department of Environmental Protection and Florida Department of Transportation June 2007), and the Florida Stormwater Erosion and Sedimentation Control Inspector's Manual (Florida Department of Environmental Protection, Nonpoint Source Management Section, Tallahassee, Florida, July 2008), which are both incorporated by reference in subparagraph 62-330.050(9)(b)5., F.A.C., unless a project -specific erosion and sediment control plan is approved or other water quality control measures are required as part of the permit. (4) At least 48 hours prior to beginning the authorized activities, the permittee shall submit to the Agency a fully executed Form 62-330.350(1), "Construction Commencement Notice," [October 1, 20131, which is incorporated by reference in paragraph 62-330.350(1)(d), F.A.C., indicating: the expected start and completion dates. A copy of this form may be obtained from the Agency, as described in subsection 62-330.010(5), F.A.C. If available, an Agency website that fulfills this notification requirement may be used in lieu of the form. (5) Unless the permit is transferred under Rule 62-330.340, F.A.C., or transferred to an operating entity under Rule 62-330.310, F.A.C., the permittee is liable to comply with the plans, terms and conditions of the permit for the life of the project or activity. (6) Within 30 days after completing construction of the entire project, or any independent portion of the project, the permittee shall provide the following to the Agency, as applicable: a. For an individual, private single-family residential dwelling unit, duplex, triplex, or quadruplex — "Construction Completion and Inspection Certification for Activities Associated With a Private Single -Family Dwelling Unit" [Form 62-330.310(3)]; or b.. For all other activities — "As Built Certification and Request for Conversion to Operational Phase" [Form 62-330.310(1)]. c. If available, an Agency website that fulfills this certification requirement may be used in lieu of the form. (7) If the final operation and maintenance entity is a third party: a. Prior to sales of any lot or unit served by the activity and within one year of permit issuance, or within 30 days of as- built certification, whichever comes first, the permittee shall submit, as applicable, a copy of the operation and maintenance documents (see sections 12.3 thru 12.3.3 of Volume 1) as filed with the Department of State, Division of Corporations and a copy of any easement, plat, or deed restriction needed to operate or maintain the project, as recorded with the Clerk of the Court in the County in which the activity is located b. Within 30 days of submittal of the as- built certification, the permittee shall submit "Request for Transfer of Environmental Resource Permit to the Perpetual Operation Entity" [Form 62- 330.310(2)] to transfer the permit to the operation and maintenance entity, along with the documentation requested in the form. If available, an Agency website that fulfills this transfer requirement may be used in lieu of the form. (8) The permittee shall notify the Agency in writing of changes required by any other regulatory agency that require changes to the permitted activity, and any required modification of this permit must be obtained prior to implementing the changes. (9) This permit does not: Project Name: Maurice Splain III Permit No.: 56-219122-002-EI Page 7 of.14 a. Convey to the permittee any property rights or privileges, or any other rights or privileges other than those specified herein or in Chapter 62-330, F.A.C.; b. Convey to the permittee or create in the permittee any interest in real property; c. Relieve the permittee from the need to obtain and comply with any other required federal, state, and local authorization, law, rule, or ordinance; or d. Authorize any entrance upon or work on property that is not owned, held in easement, or controlled by the permittee. (10) Prior to conducting any activities on state-owned submerged lands or other lands of the state, title to which is vested in the Board of Trustees of the Internal Improvement Trust Fund, the pemnittcee must receive all necessary approvals and authorizations under Chapters 253 and 258, F.S. Written authorization that requires formal execution by the Board of Trustees of the Internal Improvement Trust Fund shall not be considered received until it has been fully executed. (11) The permittee shall hold and save the Agency harmless from any and all damages, claims, or liabilities that may arise by reason of the construction, alteration, operation, maintenance, removal, abandonment or use of any project authorized by the permit. (12) The permittee shall notify the Agency in writing: a. Immediately if any previously submitted information is discovered to be inaccurate; and b. Within 30 days of any conveyance or division of ownership or control of the property or the system, other than conveyance via a long-term lease, and the new owner shall request transfer of the permit in accordance with Rule 62-330.340, F.A.C. This does not apply to the sale of lots or units in residential or commercial subdivisions or condominiums where the stormwater management system has been completed and converted to the operation phase. (13) Upon reasonable notice to the permittee, Agency staff with proper identification shall have permission to enter, inspect, sample and test the project or activities to ensure conformity with the plans and specifications authorized in the -permit. (14) If any prehistoric or historic artifacts, such as pottery or ceramics, stone tools or metal implements, dugout canoes, or any other physical remains that could be associated with Native American cultures, or early colonial or American settlement are encountered at any time within the project site area, work involving subsurface disturbance in the immediate vicinity of such discoveries shall cease. The permittee or other designee shall contact the Florida Department of State, Division of Historical Resources, Compliance and Review Section, at (850) 245-6333 or (800) 847-7278, as well as the appropriate permitting agency office. Such subsurface work shall not resume without verbal or written authorization from the Division of Historical Resources. If unmarked human remains are encountered, all work shall stop immediately and notification shall be provided in accordance with Section 872.05, F.S. (15) Any delineation of the extent of a wetland or other surface water submitted as part of the permit application, including plans or other supporting documentation, shall not be considered binding unless a specific condition of this permit or a formal determination under Rule 62-330.201, F.A.C., provides otherwise. Project Name: Maurice Splain III Permit No.: 56-219122-002-El Page 8 of 14 (16) The permittee shall provide routine maintenance of all components of the stormwater management system to remove trapped sediments and debris. Removed materials shall be disposed of in a landfill or other uplands in a manner that does not require a permit under Chapter 62-330, F.A.C., or cause violations of state water quality standards. (17) This permit is issued based on the applicant's submitted information that reasonably demonstrates that adverse water resource -related impacts will not be caused by the completed permit activity. If any adverse impacts result, the Agency will require the permittee to eliminate the cause, obtain any necessary permit modification, and take any necessary corrective actions to resolve the adverse impacts. (18) A Recorded Notice of Environmental Resource Permit may be recorded in the county public records in accordance with subsection 62-330.090(7), F.A.C. Such notice is not an encumbrance upon the property. SPECIAL CONSENT CONDITIONS 1) The applicant agrees to indemnify, defend and hold harmless the Board of Trustees and the State of Florida from all claims, actions, lawsuits and demands in any form arising out of the authorization to use sovereignty submerged lands or the applicant's use and construction of structures on sovereignty submerged lands. This duty to indemnify and hold harmless will include any and all liabilities that are associated with the structure or activity including special assessments or taxes that are now or in the future assessed against the structure or activity during the period of the authorization. 2) Failure by the Board of Trustees to enforce any violation of a provision of the authorization or waiver by the Board of Trustees of any provision of the authorization will not invalidate the provision not enforced or waived, nor will the failure to enforce or a waiver prevent the Board of Trustees from enforcing the unenforced or waived provision in the event of a violation of that provision. 3) Applicant binds itself and its successors and assigns to abide by the provisions and conditions set forth in the authorization. If the applicant or its successors or assigns fails or refuses to comply with the provisions and conditions of the authorization, the authorization may be terminated by the Board of Trustees after written notice to the applicant or its successors or assigns. Upon receipt of such notice, the applicant or its successors or assigns will have thirty (30) days in which to correct the violations. Failure to correct the violations within this period will result in the automatic revocation of this authorization. 4) All costs incurred by the Board of Trustees in enforcing the terms and conditions of the authorization will be paid by the applicant. Any notice required by law will be made by certified mail at the address shown on page one of the authorization. The applicant will notify the Board of Trustees in writing of any change of address at least ten days before the change becomes effective. 5) This authorization does not allow any activity prohibited in a conservation easement or restrictive covenant that prohibits the activity. GENERAL CONDITIONS AUTHORIZATION Project Name: Maurice Splain III Permit No.: 56-219122-002-EI Page 9 of 14 FOR SOVEREIGNTY SUBMERGED LANDS Any use of sovereignty submerged lands is subject to the following general conditions are binding upon the applicant and are enforceable under Chapter 253, F.S. and Chapter 258, F.S. (1) Sovereignty submerged lands may be used only for the specified activity or use. Any unauthorized deviation from the specified activity or use and the conditions for undertaking that activity or use will constitute a violation. Violation of the authorization will result in suspension or revocation of the applicant's use of the sovereignty submerged lands unless cured to the satisfaction of the Board of Trustees. (2) Authorization under Rule 18-21.005, F.A.C., conveys no title to sovereignty submerged lands or water column, nor does it constitute recognition or acknowledgment of any other person's title to such land or water. (3) Authorizations under Rule 18-21.005, F.A.C., may be modified, suspended or revoked in accordance with its terms or the remedies provided in Sections 253.04, F.S. and Chapter 18-14, F.A.C. (4) Structures or activities will be constructed and used to avoid or minimize adverse impacts to resources. (5) Construction, use, or operation of the structure or activity will not adversely affect any species which is endangered, threatened or of special concern, as listed in Rules 68A-27.003, 68A- 27.004, and 68A-27.005, F.A.C. (6) Structures or activities will not unreasonably interfere with riparian rights. When a court of competent jurisdiction determines that riparian rights have been unlawfully affected, the structure or activity will be modified in accordance with the court's decision. (7) Structures or activities -will not create a navigational hazard. (8) Structures will be maintained in a functional condition and will be repaired or removed if they become dilapidated to such an extent that they are no longer functional. (9) Structures or activities will be constructed, operated, and maintained solely for water dependent purposes. (10) The applicant agrees to indemnify, defend and hold harmless the Board of Trustees and the State of Florida from all claims, actions, lawsuits and demands in any form arising out of the authorization to use sovereignty submerged lands or the applicant's use and construction of structures on sovereignty submerged lands. This duty to indemnify and hold harmless will include any and all liabilities that are associated with the structure or activity including special assessments or taxes that are now or in the future assessed against the structure or activity during the period of the authorization. (11) Failure by the Board of Trustees to enforce any violation of a provision of the authorization or waiver by the Board of Trustees of any provision of the authorization will not invalidate the provision not enforced or waived, nor will the failure to enforce or a waiver prevent the Project Name: Maurice SplainIlI Permit No.: 56-219122-002 EI Page 10 of 14 Board of Trustees from enforcing the unenforced or waived provision in the event of a violation of that provision. (12) Applicant binds itself and its successors and assigns to abide by the provisions and conditions set forth in the authorization. If the applicant or its successors or assigns fails or refuses to comply with the provisions and conditions of the authorization, the authorization may be terminated by the Board of Trustees after written notice to the applicant or its successors or assigns. Upon receipt of such notice, the applicant or its successors or assigns will have thirty (30) days in which to correct the violations. Failure to correct the violations within this period will result in the automatic revocation of this authorization. (13) All costs incurred by the Board of Trustees in enforcing the terms and conditions of the authorization will be paid by the applicant. Any notice required by law will be made by certified mail at the address shown on page one of the authorization. The applicant will notify the Board of Trustees in writing of any change of address at least ten days before the change becomes effective. (14) This authorization does not allow any activity prohibited in a conservation easement or restrictive covenant that prohibits the activity. NOTICE OF RIGHTS This action is final and effective on the date filed with the Clerk of the Department unless a petition for an administrative hearing is timely fled under Sections 120.569 and 120.57, F.S., before the deadline for filing a petition. On the filing of a timely and sufficient petition, this action will not be final and effective until a subsequent order of the Department. Because the administrative hearing process is designed to formulate final agency action, the subsequent order may modify or take a different position than this action. Petition for Administrative Hearing A person whose substantial interests are affected by the Department's action may petition for an administrative proceeding (hearing) under Sections 120.569 and 120.57, F.S. Pursuant to Rules 28- 106.201 and 28-106.301, F.A.C., a petition for an administrative hearing must contain the following information: (a) The name and address of each agency affected and each agency's file or identification number, if known; (b) The name, address, any e-mail address, any facsimile number, and telephone number of the petitioner, if the petitioner is not represented by an attorney or a qualified representative; the name, address, and telephone number of the petitioner's representative, if any, which shall be the address for service purposes during the course of the proceeding; and an explanation of how the petitioner's substantial interests will be affected by the agency determination; (c) A statement of when and how the petitioner received notice of the agency decision; (d) A statement of all disputed issues of material fact. If there are none, the petition must so indicate; (e) A concise statement of the ultimate facts alleged, including the specific facts that the petitioner contends warrant reversal or modification of the agency's proposed action; (f) A statement of the specific rules or statutes that the petitioner contends require reversal or modification of the agency's proposed action, including an explanation of how the alleged fasts relate to the specific rules or statutes; and Project Name_ Maurice Splain III Permit No.: 56-2I9122-002-EI Page 1 i of 14 (g) A statement of the relief sought by the petitioner, stating precisely the action that the petitioner wishes the agency to take with respect to the agency's proposed action. The petition must be filed (received by the Clerk) in the Office of General Counsel of the Department at 3900 Commonwealth Boulevard, Mail Station 35, Tallahassee, Florida 32399-3000, or via electronic correspondence at Agency_Clerk@dep.state.fl.us. Also, a copy of the petition shallbe mailed to the applicant at the address indicated above at the time of filing. Time Period for Filing a Petition In accordance with Rule 62-110.106(3), F.A.C., petitions for an administrative hearing by the applicant and persons entitled to written notice under Section 120.60(3), F.S., must be filed within 14 days of receipt of this written notice. Petitions filed by any persons other than the applicant, and other than those entitled to written notice under Section 120.60(3), F.S., must be filed within 14 days of publication of the notice or within 14 days of receipt of the written notice, whichever occurs first. You cannot justifiably rely on the finality of this decision unless notice of this decision and the right of substantially affected persons to challenge this decision has been duly published or otherwise provided to all persons substantially affected by the decision. While you are not required to publish notice of this action, you.may elect to do so pursuant Rule 62-110:106(10)(a). The failure to file a petition within the appropriate time period shall constitute a waiver of that person's right to request an administrative determination (hearing) under Sections 120.569 and 120.57, F.S., or to intervene in this proceeding and participate as a party to it. Any subsequent intervention (in a proceeding initiated by another party) will be only at the discretion of the presiding officer upon the filing of a motion in compliance with Rule 28-106.205, F.A.C. If you do not publish notice of this action, this waiver may not apply to persons who have not received a clear point of entry. Extension of Time Under Rule 62-110.106(4), F.A.C., a person whose substantial interests are affected by the Department's action may also request an extension of time to file a petition for an administrative hearing. The Department may, for good.cause shown, grant the request for an extension of time. Requests for extension of time must be filed with the Office of General Counsel of the Department at 3900 Commonwealth Boulevard, Mail Station 35, Tallahassee, Florida 32399-3000, or via electronic correspondence at Agency_Clerk@dep.state.fl.us, before the deadline for filing a petition for an administrative hearing. A timely request for extension of time shall toll the running of the time period for filing a petition until'the request is acted upon. Mediation Mediation is not available in this proceeding. FLAWAC Review The applicant, or any party within the meaning of Section 373.114(1)(a) or 373.4275, F.S., may also seek appellate review of this order before the Land and Water Adjudicatory Commission under Section 373.114(1) or 373.4275, F.S. Requests for review before the Land and Water Adjudicatory Commission must be filed with the Secretary of the Commission and served on the Department within 20 days from the date when this order is filed with the Clerk of the Department. Judicial Review Project Name: Maurice Splain Irr Permit No.: 56-219122-002-ET Page 12 of 14