HomeMy WebLinkAboutPermit Application For Well ConstructionSTATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT,
--qEP;AIR,.MODIFY, OR ABANDON A WELL
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ell, Contractor 'Lit ensa Numbef 'Telephone Numhei E-mail Address
-881496PortSt.Lucie Ft 34988
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01 proposed Wells • MID CC
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Mended Use(s) of Well(s) Lf 7-27
C Lanascaporritfaiion Ej Agricultural Inngation rl site injesiicabon.-
hater Supply Ci RecreanonArea irrigation LivesIoM El hlonAQrIK
4teuSupply (1-fitilied , (�ey -Use Ny ,!iO 01,1on Test AUG 1 2017
CtmmdrdiVIntlustrial
iatesupply (Community oiNop-CommunitylOSP)l E50171coupled Geothermal
njection Golf Course Irrigation I
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lion.l4echarge [�:! Commerciatillmdusmai Dis 5 HVAI� Return
pq ;� C] Aquifer Storage arid . RecoY4 (] DminVIF*14 In 91 IJ
E] Recou". C] Air Sparge Other IM"Iiwi ON Ah�hHEAL
010el etsvitol;
ption Op Se es nce oate ASA.
13'Ertfmati!10,
lo Well Deplh:� 111. -E5tIMi18dCaSjn9.0ePtiI -f, . Primary Casing Diameter I :n Open Holif tom Te
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14. 1:stinjal id Scieen Inteirvil. From ro -ao ft.
Blaa Steel Golvani.,W Sliest1.5, * Frinlar�Cvsing Material
Not Cased Ulief
16t secorwair cmlrv. Telescope Casing Llmr S-wlace Casing Diameter in
17 Sewnd,ily Castrq Material elack Steel Galvanized PVC Stainless Slue[ Oln
Rota Sonic.
Combloation'i,
18 fllet?1041 Constructiori.' Repair. or.Abanoonment' Auger' Cabie Tool jetlio A�
'TWo or More Methods) Hand Driven Wlell Paint, Sand Point) Hyor-j ant (Direct Push,
Irturizuritaf Drilling Plugged by Approved Method Other
tb Flropo5io Grouting Interval !or the Primary.
Front To io a -�amentt Other Seaf'Maitedal,( Sentonite Mg:gL
To Scat Matena I I I Benttinlm ,Neat Cement Other -j
Floin Seail hialeriall Bentortile Neat Cerrient Other J
From To Seal Material Benlonite, Neat Cement Other I
20 Imical' lotai number of existing ways on site 0 List numuer of existing tinusen wells ov "He 0
i is pus wen or any.emiung web qr-watervirlthdraymkon the owner's comiguous properly cover" vivoer a Consuripth-elftiler Use Permit
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21 Datirt Obtained From, GPIS Map survey Datum. NAD 27 __14AD 83 _vvQ-S 84
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THIS PERhit IS NOT VALID Writ. PROPERLY SIGNED BY AN AUTIJORIZED OPPICER OR. REPRESENT Al IVE OF THE VIAID OR DE L EGA' E U AUT40KI, Y Tmm
PEntjlT Sl` a LL BE AVAILABLE AT THE WELL SITE DURING ALL CO%JS7Rt)C7fOk REPAIR; MODINCATNOM'. CA ABANDONMENT A.CT;IATIES
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REPAIR, MODIFY. OR AbANOONA Wft�
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DEC 19 2017
PERMITTING
St. Lucie Coun4,, FL
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SOUTHWEST FLORIDA WATER MANACEMMT DISTRICT
2379 BROAD STREET. BROOKSVILLE. FL 34604-689S
PHONE - (352) 7954211 or (600) 423-1476
VMA", SWFAVID, STATE FL. US
ST. JOHNS RIVER WATER MANAGEMENT DISTRICT
4049 REID STREET, PALATKA, FL 32178-1429
PHONE: (386) 329-4500
Y*'%AN.SJR0"VO=tA
NORTHW957 FLORIDA WATER MANAGEMENT DISTRICT
152 1VATER NIANAGEMIENT OR- HAVANA. FL 3232-3-1712
(U.S. Highway go, 10 miles westaf Tallahassee)
PHONE: (850) 539-5999
Y0!030AAJFVVMD, 81'ATE. FL, US
Permit No.
SOUTH FLORIDA WATER MANAGEMENT DISTRICT
P. 0, BOX 24680
3301 GUN CLUB ROAD
WEST PALM BEACH. FL 334 16-1680
PHONE: (551) 6815-81500
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SUWANNEE RIVERWATER MANAGEMENT DISTRICT
9225 CR 49
LIVE OAK, FL 32OaO
PHONE- (386)362-101 ot (800) 226-1066 (Florida only)
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General Site Map of roposed Well Location
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AUG 2017
FDOH in St Lude County
SWRONMENTAL HEALTH
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SOUTHWEST FLORIDA WATER MANAGEMENT DISTRICT
2�379-BROAD STREET. BROOKSVILLE. FL 34604-6899
PHONE- (352) 796-�7211 or (600) 423-14776
VA&MV.SWP4WD� STAT E,FL.US
ST. JOHNS RIVER WATER MANA611M ENT 015TRICT
4049 REID STREET, PALATKA, FL 32178-1429
PHONE' (366) 329-45CO
V",hMN,SJRW'.MD. COMI
NORTHWEST FLORIDA WATER MANAGEMENT DISTRICT
152 WA,,r E P, M A N AG ENI EN T OR., H AVAN A, FL 32 333-44 7 12
(US. Highway 90, 16 m4es west of Tallahassee)
PHO,14r'_1- (850) $39.5999
kAAN%1V,N1VF'M4D. SIA*TE,FL, US
PermtO No,
SOUTH PLORIDA WATER MANAGEMENT DISTRICT
P,O, BOX 24680
'1301 GUN CLUB ROAD
3
VVEST PALM BEACH, FL 33416-4680
PHONE: (585 116864800
SUWANNEE RIVER WATER MANAGEMENT DISTRICT
9226 CR 49
LIVE OAK, FL 32080
PHONE- (386) 362-1001 of (800) 226-10613 (Florida only)
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"General Tte heap of KOoied Well Location
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AUG 1 2017 fe,
FIDOH In St Lucie County
EWRONMENTAL HEALTH
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