HomeMy WebLinkAboutWELL PERMITMission:
To protect, promote & improve the health
of all people in Florida through integrated
state, county & community efforts.
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
S LC DOH-WELLS(a)-FLH EALTH. 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: 772/871-5360
StLuci eCountyHeal th.com
STATE OF FLORIDA PkRMI't'APPLICATION TV C :►t.S7ftUCT,
REPAIR, MODIFY, OR ABANDON A WELL
(] southwest PLEASE F-11.t OUTALLAPPI I ABLE F•IEWS
C-i Notthwest (`Denotes Required Fiefs Where Applicable)
L St. Johns River
ki. OUth Florida nm w+frer rrofl Loritrap)f is respWWLVo fuJ cv�rnpinJLtp
Suwa
nnee River MIS farm and tonvording the ponnit appiloaUon to the
U Suw olsp,urxtNJe C101"Otud A1010MY whom nppecabro.
DEP
0 Delegated Authority (IF Applicable)
P-Z31C.,X-Y7
Quad No. _ Dallnesllon--
UP Application
-Owner, L ai ame'f Corpor ti Ad
�( Sinto ZIP Telephone Number
2.
`W LoeaG n -Address R a411111110 u b 1�) ��-�--L� ._ , �Z_.t__+_�.._
"Parcel ID No. (PIN) o�A em (ClreK
e) - of
Lot Blocit Unit
4........_._ w. __...__.._.•_,o_. c �
"Section or and Grant '' - n �.., "R `CouptY Subdivision Check if t32- 4: _ Yes Ju
":Bier Well Contractor 'License Number vtephone Number C-mail Address
G. "TVA^} i(���` \�_ ttXd�it1�t7��it n 1�i
- < -
7. "Type of Work: . „ Construction Repair w_Mod(Bootion bondonma7nt
8. `Number of Proposed Wells_ •l4onuon +w Rnpnia Monmcatk,n, or Ab
g, -Speclfy Intended Use(s) of Well(s): 7fl\ I I) J
,Domestic Landscape Irrigation ____Agricultural Irrigation --Site Inyestigation u
_ Bottled Water Supply Recreation Area irrigation Y Livestock _ � Mnnitorinp r
4
Public Water Supply (Limited Use/DOH) __._,...Nursery Irrigation _ Test
Public Water Supply (Community or Nan-CommunilylDEP) _,.,_Commercial/industria) ,Eerth-Coupled Geotheraw.1 J N 2021
--
Class I Injection -._.-,..Golf Course Irrigation __•_ HVAC Supply
�HVAC Retum �
Class V Injection: --_Recharge �,� Commerclailinduslrial Disposal Aquifer Storage and Recovery,. _ Drainage
Romediation:Recovery __ „,_Air Sparge ___�_Other(ocscnbo) F OH in St Lucie County
EN IRONMEUTA6HEA Tti
_...._.-,..,.,.,,,,..__._..._(N., Nntwl ImAt on N tiro mltWd hy» ylwon pormuune nuN�aey)
iIVDIstance from Septic System If s200 R. 11. Faelli eserlptlon______, _ 12. Estimated Start Date ,aa
'13.'Estimated Well Depth lc-ffaft. -Estimated Casing DepU1 _ft. -Primary Casing Diameter__ in. Open Hole: From_ To_ Il,
14. Estimated Screen Interval: From�ToiZ-ft. �.....
15. "Primary Casing Malarial: ,.,__,_,_t3lack Steel ...--Galvanized ,_.Y PVC ___---_Stainless Steel
NotCased Other:__
16. Secondary Casing; Telescope Casing Uner Surface Casing Diameter in,
17. Secondary Casing Material; Black Steel Galvanized PVC -.Stainless Steel Other __
•t &."Method of Construction, Repair, or Abandonment: _Auger ,__Cable Tool --Jetted Jetted ,_Rotary __—Sonic
Combination (Two or More Methods) Hand Driven (Well Point, Sand Point) .__ __Hydraulic Point (Direct Push)
Horizontal griltb�p P(uggoG by ApprWed Method tither - _.
19. Propose routin t at for the Primary. Secondary, and Additional Casing:
From ToSeal Material (—-._Bantonlle_ —V,- Neat Cement Other
From Te_„_,„_„_Seat Material Belltnnite . Neat Cement Other ---—
From
. To_ Seal Material i.._.__--_ ...,...... _..__ .,...)
(,_,,_,_,_BenWnite___ _ Naar Cement, Olher�) �„
From �To,,, ,�,_Seai Material (__8entonite Neat Came nt�,Olher _ )
20, Indicate total number of axlatin.9 wails on site List number of existing unused wefla on site
21.-is this well or any wdsting well or water w• hdrawal on the owner's contiguous property covered under a Consumptive/Water Use Permit {CUP/:UP)
or CUPLatitude
1P Application? Yes _)LNo It yes, Complete the tollowing: CUP/WUP No.____.._•, _ District Well ID No.--------- co
22. LatitudeLongitude
23. Date Obtained From: ,_GPSM Map -.,,.--Survey �Dalum: NAD 27 __ _NAD 83 WGS 84
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Approval Granted By
Fee Recolwid
Issue prate W-3V-A! &( Expiration Date
Receipt No. _ �. Chock No.
Approval ,_
Inluid7
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 DURING ALL CONSTRUCTION. REPAIR. MODIFICATION, OR ABANDONMENT ACTIVITIES. Y-�+
DFP Form: 82-632,900(1) (ncurporataU in 62.8a2.4o0(1), F.A.C„ Eftemlvo ontw ombor 7, 2010 Pago 1 of 2
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Michelle Franklin, CFA -- Saint Lucie County Property Appraiser --All rights reserved.
Property Identification
Site Address: 509 N 43rd ST Parcel ID: 2407-112-0005- Account #: 19792 Sec/Town/Range: 07/35S/40E
000-4 Map ID: 24/07N Zoning: RS-4 Count
Use Type: 0100 Jurisdiction: Saint Lucie
County
Ownership Legal Description
Frederick Donghia 7 35 40 S 140 FT OF N 310 FT OF E 125 FT OF W 225 FT OF
Mary Donghia NW 1/4 OF NE 1/4 OF NE 1/4 (15) (0.40 AC) (OR 3437-2444)
509 N 43rd st
Fort Pierce, FL 34947
Current Values Historical Values 3-year
Just/Market: $40,700 Assessed: $38,894 Year Just/Market
Assessed
Exemptions
Taxable
Exemptions: $25,000 Taxable: $13,894 2020 $40,700
$38,894
$25,000
$13,894
2019 $76,100
$71,275
$46,275
$25,000
2018 $72,200
$69,947
$44,947
$25,000
Date
09-28-2012
08-22-2012
08-22-2012
View:
Year Built: 1958
Primary Wall: CB Stucco
Bedrooms: 2
Full Baths: 2
Half Baths: 0
Sale History
Book/Page
Sale Code Deed Grantor
3437 / 2444
0001 WD Barbare Donald L
3428 / 0082
0111 OA Barbare (EST) Mildred D
3428 / 0080
0111 PB Barbare (EST) Mildred D
Primary Building Information
Finished Area of this building: 1,318 SF
Gross Sketched Area: 2,197 SF
Roof Cover: Tar & Gravel
Frame:
Story Height: 1 Story
A/C %: 0%
Heated %: 0%
Sprinkled %: 0%
Y I
Exterior Data
Roof Structure: Flat/Shed
Grade: D
No. Units: 1
Interior Data
Electric: AVERAGE
Heat Type:
Heat Fuel:
Total Areas
Price
$35,000
$0
$0
Building Type: HD
Effective Year: 1977
Secondary Wall:
Primary Int Wall:
Avg Hgt/Floor: 0
Primary Floors: A TL/CON
Finished/Under Air
1,318
(SF):
Gross Sketched Area
3,081
(SF):
Land Size (acres):
0.4
Land Size (SF):
17,424
Total Building Count:
2
Special Features and Yard Items
Type Qty Units Year Bit
Driv-Concret 1 800 1958
WOOD FEN 6' 1 128 2012
CHAINLINK 4' 1 212 2016
All information is believed to be correct at this time, but is subject to change and is provided without any warranty.
0 Copyright 2021 Saint Lucie County Property Appraiser. All rights reserved.
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
HEALTH
PAYING ON: #: BILL DOC #:56-BID-5357405
RECEIVED FROM: American Drillinq 2411 AMOUNT PAID: $ 460.00
PAYMENT FORM: CREDIT CARD 041536 PAYMENT DATE: 06/09/2021
MAIL TO: American Drilling 2411
Okeechobee FL 34974
FACILITY NAME: American Drillinq 2411
PROPERTY LOCATION:
Okeechobee FL 34974
Lot: Block:
Property ID:
EXPLANATION or DESCRIPTION:
-1 - Well Construction
4
QUANTITY FEE
$ 460.00
RECEIVED BY: AdamsC AUDIT CONTROL NO. 56-PID-5041004
Note: 59-32155 - 59-32158 Y- Y