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HomeMy WebLinkAboutWell Water Applicationi o�tiu c7� STATE OF FLORIDA PEWITAPPLICATiON TO CONSTRUt:T, _4 REPAIR, N{ODIFV,ORABANDOXAWELL �.. r ,,r c 12southwest r PLEI6EFlLLOUTRLLAPPUCiieL6F1ELD9 Northwest ( Denotes R(qulrcd Fields iMer'e Applicable) �+- r= =StJohnsRiver ��'r,ye•' A�enclenrercynnaaorKresanslLrefotm ' g Guth Florida 7 mA.r;n ,���, L•j¢v q+UfiimranCfgn%rudinprrcnemitbn�lleayontorhe 0$UWanne2 i�.lVer Cyy7rGj711arSdCl."gGti�QLKIIGdrflvllCtCa/g7rail;6 Cl DEP O Delegated Authority (if Applicable) l96 'Unique ID 59-31552 Stlpulatiens Rogmd (Sea Attached) 02.524 Quad No. DotinwHon No. CUPIV6VP Application No. ,.Rodney M. Halt 6303 $. Header Canal Road Ft. Pierce; FI 34987 Ovmer, Legal Flame if Corporation . - Address City State ZIP Telephone Number 2.11771 Appaloosa Court Pnrt At I trria m Ia.otz7 ' 3. s _u9-5Ub-UU26-00D-2 23 A Parcel ID No. (PIN) orAtfemate Key (Circle One) Lot 81oc1i URIC 4. t]9 36S 39E St Lucie Pony Pines Cbeckif62-524:[] Yes Q No % Section or Land Grant Tovmship Range County Subdivision 5. James Paul Tyson 11352 054-818-4269 downthehole@attnet Water Vial! Contractor license Number Telephone Number E-mall Address ti. PO BOX 881496 Port St. Lucie. FI 34988 Water "left COntrarto?s Address City state. ZIP .7. Type of Work: ar>vIMADn ❑ Repair ❑ Modificalion❑ Abandonment S. Number of Proposed Wells 1 R==fW Ro Pat. 0.1 "fsh' 9. specify Intended Use(s) of We!!(E): Domestic Landscape Irrigation El Agricultural Irrigation Site investigations l_.1 r Bottled Water Supply � Recreation Area Irrigation Livestock �] Monitoring ❑ Public water Supply (Limited UsefDOH) ❑ Nursery irrigation Test ®Public Water Supply (Community or Non-CommurriiylDEP)❑ Commercial(industrial Earth -Coupled Geothermal APR 1 3 202 Class I Injection ❑ Golf course Irrigation HVAC Supply Class V Infection: C,l Recharge CommercfalllndustriaLDis osal HVAC Return ❑ p ❑ Aquifer Storage and Recovery ❑ Drainage Remediation: ❑ Recovery[:] Air Sparge Q Other IDeacribe) DOH In St Lucie Cc r] Other loa,cdbo) 10. Distance from Septic System if 5 200 fL + 11. Facility Description repose eft. ence 12. Estimated Start Date 113. Estimated Well Depth 1.00 fL Estimated Casing Depth 80 R Primary Casing Diameter 2 in. Open Hole: From 14. Estimated Screen Interval: From 80 TO 1.00 % 18. Primary Casing Material: Block Steel Galvanized Statnien Steel Not Cased Qtiier. 16. Secondary Casing: Telescope Casing Liner Surface Cesing Diameter irL 17. Secondary Casing Material: BlacteSleel - Galvanized PVC Stainless Steel ter 1a. Method of Construction, Repair, or Abandonment_ Auger Cable Tool Jetted Sonic Combination (Two or blots Methods) Harrd Driven 6NIeli Paint, Sand Point) Hydraulic Point (Direct Push) HorizontahDrtiling Plugged by Approved rlethod Other (o�ztn ) 19. Proposed Grouting Interval for the Primary, Secondary, and A t Zsing: Front_ To 75 Seal Material ( Eentonite -a�'Ce Other 1 From I To Seal Material( Bentorrile Neat Cement Other ) From To . Seal Material ( Bentortite, Neat Cement Other From To Seal Material ( Bentonite Neat Cement Other_ ) 20. Indicate totai.number of existing wells on -site 0 List number of existing unused wells on site 0 21. Is this v1eU or any existing well or water vhthd n iha owner's contiguous Pprope rty covered under a ConsumpfiveNVater Use permit (CUPIWUP) or CUPAJVUP Application'? Yes .eves, complete the foliowirrg: CUPNUUP No. District Wall 10 NO. 22, Latitude Longitude 23. Data Obtained From: GPS Map Survey Datum: NAD27 NAD 83 1RrGS 84 lbwcby C-9.1imitti ntnel%w(.4 cho sT°saL'c,�radT�t ae nmae, a.!�.:.:.....e.._r:.,_.. 1—_.._..._ .. _ Approval Granted 11352 License No. ign-lure of %net or ]me DeroMW Eoration Pea Received S-- 9 _ —�— rR:rss Receipt No. r / Check No,_ THIS PERMIT IS NOT VALID UNTIL PROPERLY.SIGNED SY AN AUTtIORIZBD OFFICER OR REPRcSENTAT{VS OF THE l pxm PERMIT SHALL BE AVAILABLE AT THE WELL 61TS OURINGALL CONSTRUCTION, REPAIR, MODIFICATIolL OR ABAND ', [DJ APR 19 n:1 ST. Lucie County, Permitting t s �t wit ►,Lj <14W ��,.a r f � ", �./►�,'. ';� i�i17 R {CIO�l+t ,.! F$F �.. ..� �'�� 3rg*r.,,� f� � � n, x- Lur y►SI KNj�t�y, . ' �„ +ii I a y � r.�tw, � s v y..�I i Zr�CW:,�t,pUf.T • , ZRY M1r•1/Oi !.C?Ij4 It7 - - ....r. r�.u`t�.�, r_....�.... e. • :, .t 7'+ .,.�""'.. .. �tj;{TG�.iT� Michelle Franklin, Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved. w Property Identification Site Address:11771 Parcel ID:3309-605-0026- Account #: 35526 Sec/Town/Range:09/36S/39E APPALOOSA CT 000-2 Map ID: 33109N Zoning: AG-2.5 - C Use Type: 0000 Jurisdiction: Saint Lucie County Ownership Legal Description Rodney M Hall PONY PINES -UNIT ONE BLK A LOT 23(1.89 AC) 6303 S Header Canal RD Fort Pierce, FL 34987 Current Values Historical Values 3-year Just/Market: $78,200 Assessed: $78,200 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $78,200 2020 $78,200 $78,200 $0 $78,200 2019 $66,100 $66,100 $0 $66,100 2018 $66,100 $66,100 $0 $66,100 Date 02-14-2019 10-18-2018 03-01-1983 View: Year Built: N/A Primary Wall: Bedrooms: 0 Full Baths: 0 Half Baths: 0 Sale History Book/Page Sale Code Deed Grantor 4233 / 0396 0001 WD Lopez II Reinaldo L 4195 / 2127 0061 WD Lopez Aguiar Henry A 0396 / 1116 XXO l CV Primary Building. Information Finished Area of this building: 0 SF Gross Sketched Area: 0 SF Exterior Data Type Roof Cover. Roof Structure: Frame: Grade: Story Height: No. Units: 0 Interior Data A/C %: 0% Electric: Heated W N/A% Heat Type: Sprinkled %: 0% Heat Fuel: Building Type: Effective Year: N/A Secondary Wall: Primary Int Wall: Avg Hgt/Floor: 0, Primary Floors: Price $90,000 $75,000 $9,000 Total Areas Finished/Under Air 0 (SF): Gross Sketched Area 0 (S1=): Land Size (acres): 1.89 Land Size (SF): 82,328.4 Total Building Count: 1 Special Features and Yard Items r Qty Units Year Blt All infonnation is believed to be correct at this time, but is subject to change and is provided without any warranty. ©Copyright 2021 Saint Lucie County Property Appraiser. All rights reserved. "f. St. Lucie Count Health Department �Y P RON 5150 NW Milner Dr Port Saint Lucie, FL 34983 HEALTH PAYING ON: #: BILL DOC #:56-BID-5184062 RECEIVED FROM: Down the Hole 11352 AMOUNT PAID: $ 1005.00 PAYMENT FORM: CREDIT CARD 046395 PAYMENT DATE: 02/17/2021 MAIL TO: Down the Hole 11352 PO Box 881496 Port Saint Lucie FL 34988 FACILITY NAME : Down the Hole 11352 PROPERTY LOCATION: PO Box 881496 Port Saint Lucie FL 34988 Lot: Property ID: EXPLANATION or DESCRIPTION: -1 - Well Abandonment -1 -Well Construction 1 Block: QUANTITY 4 7 FEE $ 200.00 $ 805.00 RECEIVED BY: AdamsC AUDIT CONTROL NO. 56-PID-4887690 Note: 59-31551-5931561 5� �3v515 �, Qom, •