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HomeMy WebLinkAboutPermit Application For WellSTATE OF FLORIDA PERMIT OPLICAMN. TO CONSTt UCT, -REPAIR; MODIFY, OR ABANDON A U4tELL ' Permit No _� 59.32407 ,• Florida Unique ID CI Southwest PLGASEFIUOUT ALLAPPUCAdLEFIELDS 0 Northwest ("Denotes #required Flelds Where'Appiicable) Parinit Sflpulauans. Required (Sea vlttachaC) a 0 St. Johns River 0South Florida n7e t' 'f s'airrnnUac(or'sresAnnsiile forcomytetitg this (arm and fonvardiri� thaparm�i appiiv3Gon tvtfle 82-524 Quad No... Delineation iVo.___�,_„_�_� ik N5 DSuwannee 'River apnrctpdate.thrleyatadatrth'aritywheranppNcttpfa' a.. Q DEP CUPtWKJPApplieaGon Kv .. 0 Delegated ftuthority (if Applicable) • -• .- 'Owner, Legal Name if Corporation 'Addre °C- "'State ?ZIP . Te(ephone Number `Well Location -Address, Road Name umbor, City gParrel tD o. (PIN):orAlternate:Key (Cir Ie One) Cot. :'Block Unit, ' J rr7 i `�� IA t .3. Check if 82-524: Yes r�lo ;avetftarr©r., an Grant .}} TO hi 'Range. : dCourity Subdniiston . �� ri— 'Water Welt Contt r 'tcense Number. "Telephone Number mailAddress lWater WeIC obtractaft Address: i State ZIP 7 "1•ype bfftrk.' .�s fistuOVZF �" Repair __ _ Modiiicatlan Abandantnent i $ Number ofi Proposed Wells `Rxason rrnRatxttc. arndincarian, arA6aruinnmwnt 9 'Specify Intended Uses) of Weli(s) 'cultural Irri ation. Site Investi anon I DamasuG. _' , ,•Landscape Irrigation 9 � 9. 8 ;BoitledWater Supply _f2ecreafianAreafriigatiori �Livestook. _1Nonitoring Nu�seryirngation Test Public Water Supply (United UseIDOH) "`Commercial/Industrial Earth -Coupled Geothermal `' p ry -p PublicwaterSuppfy(Community orNon-Community/DEP)---- AUG G ! 20� �GoffCoursefrzlgaNan: ,,__„HVAO:Suppty. Class l injeetiori V? 'RetUtn Class V injection:. Recharge Cvmmerc'raltindustrial Disposal�Aquitar Storage'alnd Recovery r.: Drainage . Remediation: Recovery _Air Sparge_Qther feesctibef OH 9f1 St.L1a1Cie CO �/ Other (Resa wr) (Note: Not an types vraURare m rNrtPd by a elvenrynrmltung auUmctty t0 •Distance from Septic System if s200 ft :11. Facility Doscnptfon Y = 12, Esbmatsd Start I'Date 15."Estlmated Well Depth :n.­64. ^Estimated Casing Dopth, l U ft "Primary Easing DiatTiet9r in Opan:Hale : Prom To ft 14. Estimated Screen Interval: From 8 To0_ft: 1fi 'Primary Easing Material: Black Steel Galvanized t?SfG - Stainless: Steel Not Cased Other: 16, Secondary Casing: Telescope Casing Liner Surface Casing IXameter in.. . 17. Secondary Casing Material: Black Steel Galvanized ...PVC Stainless Steel Other . 1$ tvlethodofConstruction, Repair, orAbandonmenC Auger CataleTvoI . Jetted , 4%Rotary, ' Sonic Combination (Two -or More Metha s) band Driven (Well:Paiiit;'Sand Pvfnt) r{ydratitic:l'tiirii (Direct Po h); Florizonfai3Otilling Plugged by:Appraved Method:, Othertrroemr•t 6 18 Pro posed Givuting Interval for the Primary, Secondary, and Additional Casing: FfvrrtSeof Material Bentonfte Neat Coment Oftr ) From Tba' Seal l Material (,�,„Bantonifa Neat Bement Other } Froryt To SeatMatedai benloniie Neat.Gement Uhler ) From To Seat XAatedal't ' Benfonfte i leaf Gerrient Other ). 20.lndtcate:to6.1 huinberof existing wells on site UstnumberoFexisting unused Wells oil site 21,15 this wellorsnyaxlsting well orwaterwithdratvai on the owner's contiguous property covered'undera Consumptive/Water Use Permit (CUPIWUP s District Well: -ID No or CUPWUPAPikation7 YeaW .. . 22; Latitude Longituide 23.DataObtained From: CPS Map Survey Datum: NAD27 NAD8 WGS84 'Fhoe•tyro+tiN•brlivttwmCtrtiitb lFO SPpkeo6L7 rtdnot itt}ade; rtondaAdrer eiutivuCndg; mdnin;e Wator IccafQy ttytl.im(Gooym4rere cwx�n'ifc lr+r Nna�rm.O.Iktrppyl4iXn5MWID10; mxrtlVttph'Trg't, t4f�r�y ' • uze�zmart�rdaireeMri�epenn8;'Onitided.vsaanerwtsbeotminedprtartoanmencecrtemdrs'a!1 nr•�po�2¢+ocavnecrCtie�rer3r3.itx+dasuures:tomsn4iaucroac.7i'aw•�ncrbnthts�eiroclaxig9�.kimrr emetrm"Ya. 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THIS PERMIT 19 NOT VALID UNTIL PROPERLY SIGNED 'BYA14 AU OR D OFRGEROR REPRESENTATIVE OF THE WMD ORDELEGATE13 At)THORITV. ` t PERMIT SHALL BeAVAIL.ABLE AT THE WELL SITE DURINGALL CON UCTION, •REPALR, MODIFICATION, OR'ABANDOMMENTACTIVITIES. DEP Fawn; 62-53.2.9ad(1) Incorporatedlnfi2-532.d00(:1), F-A:C: ;EffktivaVil :-October7,'2010 ? f se I oft SET CAP 7 .O O ��D 0A SET CAP r-- - .COL EXISTING SWALE 10'IUTILITY + DRAINAGE EA5EMENTep� �+ ' ° 01 0. A U G 2 7 2021 ;01 5G3 50. FT. vl UNOBSTRUCTED AREA FDOH in St Lucia County ENVIRONMENTAL HEALTH wvL 39.0' 10.5' BLOCK S Q Q LOT 10 Q PROP05ED N o 1 STORY N CB5. #7408 0 DT q ANT AG EXISTING pp 4 0' a S OR SEPTIC 15.0' v0'• O O PORCH °O PROP: _ 25.5' _ / 19.0' i� GARAGE GONG. � EL .-23.5' A/C PAD` „Q EL.-23.5 EF / 20.0' nnn a 1.i.z / -= \ �L90 ,ya 4 2F' ROP. io / GONG. PROP. WALK "CONC.- 1-2 / DRIVE 19O. 4 "I jam_ (WELL v b tit \\gm 6NIM 0* 0_ •IG.O' SET CAP -� 75.00 ` FND I - Ig 02'E A _ _ 00"oo PROP. '12' GMP _ _ EXI5TING 12, Cr GL EXISTWG SWALE {{ EL.=18.6' EL.m18.5' i"�8.4' co SET T13M „ ON PK EL.-20.50' 5/�N G/�RL O S l�f �. , 01 --_. . -;::;2 -