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HomeMy WebLinkAboutAPPLICATION TO CONSTRUCT STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT,
REPAIR,MODIFY,OR ABANDON A WELL Permit No. ,... 59.32465
FY11Esp yo Irao t i Southwest PLEASE FILL OUI ALL APPLICABLE FIELDS Florida Unique 10
I Northwest ('Denotes Required Fields Where Applicable) Permit stipulations Required(Solt,Atlar:hcd)
: ;:I St.Johns River —__._._�._.__.._._....-__......_..__.
z The waier well rontraclot ix re;;pousibre fol coniptehrlo
y, I 1 South Florida this torn)and brwaraing the permit applcuaur,to the 62.524 Quad No......_____Dolinr,:uldn Nu __,• _. _.
.,Suwannee River apprhpnatr delegatedournonty where apparnato
cob wz thou• ["I DEP CUPiWUP Application No.,,
I-]Delegated Authority(If Applicable)
IYI YCu'n,. t Id E t+CtcL abj Iridtclr� F><i1is •Dr FF�'i&c-e F� 3 YSa 873- l0?07
'Ow r.Legal Name if Corporation 'Address 'City 'Slate ZIP Telephone Number
2 713p .'D.-IC) "�, ►i 5f WiCle. TL 3ggsa
'Well Location-Address.Road Name or Number.City
3. 34)4- 15D1-I q)a--J DD- / Lot Block Urn)
'Parcel ID No.(PIN)or Alternate Key(Circle One)
- # Lve�e C�< r�(Pl?S ..!•a •- Chec5cif 62-524: Yes No
'Section or Land Grant 'Townsh'p 'Ran 'County Subdivision
5.J'Witr�We•l.'��c�b•s�s �r1c.Lt.-. �Itt:,yts ��3�.� �.� ' br�•`�O� S�_�v.iC�,\ri_�Z,'a.� <<aWri�r'�.��1,.�:A`t`!`
ll Contract r 'License Number 'Telephone Number E-mail Address
--- _ _- — __._. .. �..__ .....__....._ _.�9?1 _..
6 61'Water Well Contractor's Address Cit — State ZIP
7 'Type of Work. _Construction •___• Repair __ Modificalton _Abandonment ___�_•__-_______.__
'Number of Proposed Wells 'Reason'or Repair,Modlflcahon of Abendonlnerlt
9,*Specify Intended Use(s)of Well(s).
r!� W v
Domestic -.—Landscape Irrigation _,Agricultural Irrigation investigation
„ Bollled Water Supply ..—Recreation Area Irrigation _.._Livestock _Monitoring
Public Water Supply(Limited UseIDOH) Nursery Irrigation Test NOV 2���
Commercial/lndustnal . Earth-Coupled Geothermal
Public Water Supply(Community or Non-Community/DEP) Golf Course Irrigation HVAC Supply
Class I Injection HVAC Reluril
Class V Injection _Recharge Comrnercrat/industrial Disposal--Aquifer Storage and Recovery——_Drainage OH in St Lucie Coun
Rennedlalwn. . Recovery AirSparge Other;ooscfnial . , . E VlROPQ14t AIhTAt'�HEA H
Other toescnhel_ _ _iNniA Net ei,types n'wn Is ate permitted by a groan p,:hnilbn�i auiho(Ay) ,
10 'Distance Irom Septic System it.200 It. '/ _. 11.Facility Description Sing fe f 1 N 12. Estimated Start Date
13'Estimated Well Deplh,00•ft. 'Estimated Casing Depth__...... h. 'Primary Casing Diameter .• in. Open Hole. From To. ft.
14 Estimated Screen Interval.From To ft.
15.'Primary Casing Material. _Black Steel _Galvanized w•_•,PVC ___,Stainless Steel
Not Cased Olhe(.
16 Secondary Casing: __Telescope Casing •__`Ltner ,Surface Casing Diameter---—tn.
17 Secondary Casing Material: ._• Black Steel Galvanized PVC Stainless Steel Other
18-Method of Construction.Repair,or Abandonment. . Auger >� Cable Too) _ . •Jetted Rotary Some
Combination(Two or More Methods) Hand Driven(Well Point,Sand Point) ..Hydraulic Point(Direct Push)
Horizontal Drilling Plugged by Approved Method ..,Other
1g Proposed Grouting;Interval for the Primary,Secondary,and Additional Casing.
From ___•_.._.To Sea!Material(_i Bentonite Neal Cement,_•_,,Other_•_•__�, ,_•___ .,_..,)
From _ To Seat Material(__•_Bentonite Neal Cement Other_ __ )
From To Seal Material( • , Bentonite Neat Cement Other., • )
From To••_ Seat Material(• ••_ _Bentonite Neat Cement. . Other )
20 Indicate total number of existing wells on site__Q List number of existing unused wells on site.
21 'Is this well or any existing well or water withdrawal on the owner's contiguous properly covered under a Consumptive/Water Use Permit(CUP/WUP)
of CUPIWUP Application? Yes X No If yes.complete the following.CUPIWUP No. District Well ID No
22 Latitude ._.._._.___._...._._..___.__...... Longitude---.........
23 Oata Obtained From:__GPS _-Map _Survey Datum __NAD27 • NAQ 83 ____,,WGS 84
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'Sig a of Contractor License No. S u 9 9 g C
Approval Granted By issue OarExpiration Oate 3 �idZ3 F•Iydrolugisi AfKlruval
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Foe Roceived $_. Raceipl No ._ .._.. Check No. .. ., .. _...
THIS PERMIT IS NOT VALID UNTIL PROPERLY SIGNED BY AN AUTHORIZED OFFICER OR REPRESENTATIVE OF THE WMD OR DELEGATED AUTHORITY THE
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Michelle Franklin, CFA-- Saint Lucie County Property Appraiser--All rights reserved.
Property Identification
Site Address:Dyer RD Use Type:0000
Sec/Town/Range:25/36S/40E Account#:41201
Parcel ID:3414-501-1412-100-7 Map ID:34/25N
Jurisdiction:Saint Lucie County Zoning:RM-5-Cou
Ownership
David Ingram
Alicia Ingram r � +
201 Indian Hills DR M s• ° t - �.
Fort Pierce,FL 34982
Legal Description �F
ST LUCIE GARDENS 25 36 40 BLK 2 S 165 FT OF N 330 FT OF LOT 12
(1.31 AC)(MAP 34/25N)
Current Values
a�8s
Just/Market Value: $70,400
Assessed Value: $35,271
s :a
Exemptions: $0 •-,�u x' '�� �.� ,.. ,e..?. D �.-: �1 ._:.�.��e�:_�
Taxable Value: $35,271
Total Areas
Property taxes are subject to change upon
Finished/Under Air(SF): 0
change of ownership. Gross Sketched Area(SF): 0
Land Size(acres): 1.31
• Past taxes are not a reliable projection of future taxes. 57,063.E
The sale of a property will prompt the removal of all Land Size(SF):
exemptions,assessment caps,and special classifications.
Building Design Wind
Taxes for this parcel: SLC Tax Collector's Office
Download TRIM for this parcel:Download PDF© Speed
Occupancy Category I II III&IV
Speed 140 160 170
Sources/links:
All hiformation 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.
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
PAYING ON: #:56-SF-2367576 BILL DOC#56-BID-5586092 CONSTRUCTION APPLICATION#:AP1728701
RECEIVED FROM: Homecrete Homes AMOUNT PAID: $ 660.00
PAYMENT FORM: CREDIT CARD 7836a _ PAYMENT DATE: 09/07/2021
MAIL TO: David and Alicia Ingram
FACILITY NAME :
PROPERTY LOCATION:
TBD Dyer Rd
Port Saint Lucie, FL 34952
Lot: 12 Block: 2
Property ID: 341450114121007
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 52 j (a 5 1 $ 115.00
RECEIVED BY: EvansJS AUDIT CONTROL NO. 56-PID-5224035
Ron DeSantis
Mission: Governor
To protect,promote&improve the health
of all people in Florida through integrated -' it
state,county&community efforts. HEALTH Joseph A. Ladapo,MD, PhD
State Surgeon General
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(c-D-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-WELLSCU)-FLHEALTH.GOV
• Submit revisions to permit and/or site map within 48 hours of well construction or
abandonment.
Florida Department of Health-St Lucie County
Division of Disease Control and Health Protection
Bureau of Environmental Health
Location:3855 S US Highway1,Fort Pierce,FL 34982
Mailing:5150 NW Milner Drive,Port St.Lucie,FL 34983 Accredited Health Department
Phone 772-873-4931 Public Health Accreditation Board
Fax 772-595-1306
FloridaHealth.gov