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HomeMy WebLinkAboutWater Well PermitsC '4' A r Ron DeSantis Mission: Governor To protect promote & improve the health %. of all people in Florida through integrated ° Scott A. Rivkees, MD state, county & community efforts. HEALTH State Surgeon Genera! Vision: To be the Healthiest State in the Nation 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@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 5150 NW Milner Drive • Port SL Lude, FL 34983 PHONE: 772/462-3800 • FAX T721871-5360 StLucieCountyHealth.com Accredited Health Department • : Public Health Accreditation Board �. STATE;Q _FLOivI©A ERMit. OkiCATITff. ;GONS7RUGT 59-31691 ORAB�INDOAf A1tIfEL1Y : Permlt No._ Ftagda_tdnigge t0 . PlF.ASE FILL OUT AIE. APPllCABLE FIELDS DtVorfhwest': ('Debates;ReguiiedFeldsWfi'ereApplica6le} P.erinit:Stipulations'Required(SeeAtiachedj p SL-Johns River 17Sriutia Plonda+ewaterweUcontraetorFsresppnsr3leforcomp(eGrtg iliTsfgnmantllomranfmgu+epemtiiappGra►ronYo:the ti2,524QuadNo. t)elinea6oniVa x UUila11t18iEZtV2E: aPjiiuAiiafedelegatetla+4fion7yRhere:applicable.: - L1PEP - CUP/WUP.ApplicationNo. �... . 0 Delegated Auttiority:(Ef Applicable) :a •- o 0 ,. inn�lh -or,�► Coi�,��e .• 1G:;'• � �;_ :. �a�i�w=�s1�:��� '-�t�_ �tir�e�,=�_ �"-� :' • . _ yOwner, Legal tJanie=if Corpiirafiori ., °Address ty}fb rr 1j03 *Ctiy "Sfafe :`ZIP rrelephone Number z _ " 10(o.10-i ��,ne. Needle Dir::`. Ft :Pvtru �1 .::%LOL s -'Well Location=Addres%:Roadhfaine of Numbei; City: 3. 232V 002 .ix 5 odoq.: `ParceLlD:(Vo::{PINjorAltemate-Key(Ci[cleOne):,-".;.:;" '.: :' _-:_ Lot Block Unit 4. �1 : 355 39 E�.. 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Expuahori Date •9 ` � F�dm1o6& Ap Fee Received:S .: -. • ..: ... - .. ::Receipt Tto:: Check No. THIS PERM(T'ISIVOCl/ALIaUN71f5PRQPER(J'SfGNEU8YAN. UMORtZECTOFF(GERQRt�EPRESEN�A7iVEOFIEiEWililQOIiUELEGATEDA[IfH RIMY THE " PERffi11%StiAltBEAV�jIL4BI�BATli�EWELtSI EDUf21NGAlLCON5TRl1G710N,;RF3AiR,MODIF7C/44iON,O.R=i9BIW_ONMENTi4C. JVMES..- DEP Form1.62S3Z9tiU(1)'" lficorpnrateii,iir ti2S3?1W0(1) FJICc::.F_ffective Dafe _OCtotierT,'2ni0 ( Page T of 2 i :),93 i 0 J n 35.2' F-1 M C6 co /I LOTS IBIVEHOLLOWUMTywo VACANT x 16.00 14.3' COVEBED 17.0' N PORCH Iv �18,70.7' 18.0' g, w PROPOSED hill I of ! I STDRYCBS I I SEPTIC ! I o AREA IM =19.8Y 18.0' 7.0' 11.3' 11.3' 34.9' 14.3 1 54 COVERIJ ENTRY x 15.77 zz il op 52.8' AQ--4 0 mD bo 13 PROPOSED WELL & WATER LINE ai x 18,52 I I 8.0' d a S, 2 14.6 E dig ° "° IC 16.17 18.18 12.5' I I ° a ° oo I a a. .a X .99 a - -a IIUW St. Lucie Coun�jr Health Department HEALTH 5150 NW Milner Dr Port Saint Lucie, FL 34983 PAYING ON: #: 56-SF-2252704 BILL ooc #:56-BID-5206726 CONSTRUCTION APPLICATION #: AP1639020 RECEIVED FROM: James Trefelner AMOUNT PAID: $ 660.00 PAYMENT FORM: CHECK 2205 PAYMENT DATE: 03/18/2021 MAIL TO: Kenneth & Candice Langel FACILITY NAME: PROPERTY LOCATION: 10610 Pine Needle Dr Fort Pierce, FL 34945 Lot: 3 Property ID: 2321-802-0005-000-9 Block: EXPLANATION or DESCRIPTION: QUANTITY FEE 128 - OSTDS Construction System Inspection Research Fee 1 $ 5.00 -1 - Surcharge (All) 1 $ 45.00 -1 - OSTDS New Permit Surcharge 1 $ 100.00 -1 - OSTDS Construction Application and Plan Review,New 1 $ 100.00 123 - OSTDS Construction *Site Evaluation 1 $ 115.00 126 - OSTDS Construction Permit (New or Mod, Amendment) 1 $ 55.00 127 - OSTDS Construction: System Inspection 1 $ 75.00 133 - OSTDS Construction Reinspection 1 $ 50.00 -1 - Well Construction 1 $ 115.00 RECEIVED BY: AdamsC AUDIT CONTROL NO. 56-PID-4907430 Note: Well - 59-31691