HomeMy WebLinkAboutGENERAL INFORMATIONSCANNED
BY
0. Lucie County District Use Only: No. 7,! L.5- - 0" —Q� `�-
TORT plE, RCI!; FARMS WATE, R CONTROL DISTRICT
("District")
14666 Orange Avenue • Fort Pierce, Florida 34945 a (772) 461-5050 - FAX (772) 46I-9446
Apnliention to Connect to, or Use, District Facilities, or for Utility Construction*
A. General Information:
Applicant Information:
Name:
Address:_ 9116 em rno(r f/d
rZ,J_
Telephone:
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Engineer of Record Information (if applicable):
Owner Information (if different from Applicant) -
Name:
Address:
Telephone: ( )
Email:
Billing_ Contact Information:
Name: Name:
Address: Address:
Telephone: ( 1 Telephone: ( )
Email: Email:
B.' Project Information: (Check appropriate box and attach drawings to show location and details):
❑ Culvert Connection to District canal for irrigation or gravity drainage,
❑ Pump Connection to District canal for irrigation or drainage.
]Installation of culvert or water control structure in District canal for crossing or water control.
/❑` Utility Crossing:
❑ Electric ❑ Telephone ❑ Gas
❑ Cable Television ❑' Water Main ❑ Force Main
FX Other (specify):
�ti G Irk �'Tr lrJ�.d �2t c is s
Location: Section(s): , Z(n Township: 3`-(5 Range: _
Description of Indirect Connection:
Drainage area served: acres (Culvert or pump Connections.)
31 r Canal No.: 15-
C. Construction Selredule:
Estimated commencement date: - I - /s Estimated completion date: " l ` b
D. Application, Use Fee: $ �� • Review Deposit: $
(Submit fee with this application in accordance with the District's fee schedule.)
ACKNOWLEDGEMENT AND ACCEPTANCE:
As reflected by my signature below, I hereby certify that the information shown above is accurate to the best of my knowledge, and that I
agree to satisfy or abide by all requirements of this Permit, including "Standard Provisions" itemized on the reverse, and "Special
Conditions" imposed by the District. Further, I acknowledge that the District and its Engineers are doing work to benefit the property and
non-payment may result in frlin a construction lien as permitted by the Florida Statutes.
Owner Signature:
Owner Name rfype or Print): PA/Z) w�(L
Date: R'r1 6
STANDARD PROVISIONS
for
Application / Permit No,, d fS' 666 -G O S
If this Application fora Penult Isapproved. I do acknowledge, understand, and agree that:
1. I hereby Indemnify and hold the District harmless from claims for property damage or personal Injury arising from the Installation
or use of the permitted facility, and that this Indemnification extends to damage to the hdllty itself that may occur from District
operation and maintenance work.
2. Approval of this application does not relieve the Perms tee from securing any and all other permits that may be required by other
entities or governmental agencies, Including, but not limited to, the South Florida Water Management District, the Florida
Depafdnent ofEnvironmental Protection, and St Lucie County.
3. The use of, or construction within, the District's right -of --way shall conform to the details of the attached approved drawings
supporting this application. Modifications must be approved by the District in writing BrJ.41: to construction.
4. If required In the interests of the District's operation and maintenance program, or by any modifications to the District's Standard
Pmvislons, I agree to alter, replace, relocate, or remove the permitted facilities at no cost to the Distrlct, all as is more fully set
forth by District Policy Resolution duly recorded In O.R. Hook 673 at page 224 of the Public Records of St Luck County,
Florida, but subject to the limitations thereof.
S. The lands to be benefited by this application are, or may be, subject to flooding draiug pceIods of hlgb water resulting from heavy
rains or other acts of God. This Permit will be accepted subject to this possibility, which is recognized not to be within the control
of the District.
6. Any other requirements that maybe imposed by the District are binding upon me, my successors and assigns.
7. Any Permit issued as an approval of this application other than -one issued in irrevocable, recordable farm pursuant to the Policy
Resolution referenced In Item 4, above, shall not be transfuable from the Pemtittee to a subsequent owner or owners of all, or a
portion og the subject property without the express, written approval of the District
S. Any Permit issued as approval of this application Is strictly subject to all of the rules of the Distric4 duly promulgated from time
to time, which are on file and available for examination at the offices of the District by those having interest
9. If a Pemdt is granted, I shell notify the District not less than 24 hours prior to the bcghming and completion of the work, to
enable the coordination and scheduling of fnspeetlons,
10. I accept total responsibility for any eroslon og or shoaling in, the District's right-of-way or canals that results from the permitted
work, and I shall repair or remove some promptly, at no expense to the District
11. During and after construction, I shall prevent material from the construction area from being discharged to, or settling In, District
canals,
12. Unless authorized by Permit, I shall neither place, construct or plant, nor cause to be placed, constructed or planted, any object or
Improvement within the District right-of-way without the express written prior approval of the District.
13. Within thirty (30) days of completion of the work, I shall submit a written statement to the District certifying that the work was
performed and completed In accordance with the Permit and tie approved drawings. If the work deviates from the Permit or
approved drawings, the certification shall state the nature and extent of those deviations.
14.If this Permit is for a drainage connection, then drainage discharge from the area served shall not exceed the volumetric
equivalent of 2.6 inches of depth over the area for any 24-hour period (30 gallons per minute per acre) from the 10-year
frequency, 724wur duration ndnfidl.
13. If a Permit is issued for a hydraulic connection of property with a District canal, I shall not discharge hyacinths or other aquatic
vegetation into the District canal.
16. The Permlttee, his agents and contractors, shall conduct the work In a manner that will not impair the use, or potential use, of the
District right -of --way and facilities. In no case shall drainage or i dpdon canals or appurtenant works be obstructed or restricted.
17. All irrigation and drainage connections to District facilities shell be clearly marked with a post of contrasting colors to identify
the location and extent of the permitted installation.
18. If access Is permitted via an existing culvert crossing installed in District right-of-way, the Permittee Is advised that the crossing
may be permitted for use by other affeeeed owners, as such crossings are limited in number by the District
19 The District reserves the right to permit the use of culvert crossings installed in rights -of -ways by other affected owners of
District lands, as culvert crossings are subject to distance limitations imposed by the District
20. All utility InsWhWons shall be clearly marked with above -ground signs or markers, as required by the District's °Permit
Information and Criteria Memral."
September 14, 2015
Canal 5 Culvert Crossing at 3195 Seminole Rd.
FPFWCD Permit Application._No. 01:5=006-005
Permit Conditions
1. The FPFWCD Board of Supervisors has approved this permit for the proposed culvert crossing to
consist of 96" CMP. The design invert elevations of the proposed 96" CMP shall be confirmed by
the District Engineer as specified below in Permit Condition No. 2.
2. Prior to construction and in lieu of construction drawings, the permittee shall provide .the District
Engineer the invert elevations of the existing 96" CMP located approximately 690 feet north of
the proposed culvert crossing, the existing 84" CMP located approximately 660 feet south of the
proposed culvert crossing, and the existing culvert crossing located downstream at Immokolee
Rd.. Additionally the permittee shall specify the proposed end treatment for this crossing (e.g.,
concrete -end wall, sand -cement end wall, rock rip rap, etc.)
3. Two (2) weeks prior to construction, the permittee shall contact the District Superintendent of
Works, Steve Cassen sat (772) 216-4960, to schedule a site inspection.
4. The contractor shall provide the FPFWCD with a 24 hour contact number and personnel for
emergency situations.
5. Within 30 days after completion of the permitted activity, the permittee shall submit notice of
completion to the District for approval. This shall consist of a written notice of completion letter,
and two (2) complete sets of the final "Record Drawings" or as-builts, signed and sealed by a
licensed surveyor. These statements must specify the actual date of construction completion and
must certify that all improvements have been constructed in substantial conformance with the
approved permit and will function as intended and designed. All surveyed dimensions and
elevations shall be certified by a registered surveyor.
6. The permittee shall be responsible for all permit application review fees associated with this
permit application.
7. No materials or equipment may be staged within FPFWCD rights -of -way without prior approval
from the District Supervisor of.Works. If the contractor wishes to seek approval to stage within
FPFWCD right-of-way, the contractor shall submit a staging plan to the District at least 2 weeks
prior to the start of construction staging for review and approval. Additionally, if approval is
granted for staging with FPFWCD right-of-way any regarding of the construction staging area
shall be such that the bank area is sloped from the top of bank away from the canal section.
Pursuant to the FPFWCD Permit Information and Criteria . Manual, the installation and
maintenance responsibility for the use of, or construction of facilities, in, on, or over District rights -
of -way (including, but not limited to, riprap and culverts) shall be that of the permittee or the entity
identified in the permit. Failure to maintain the permitted use or works may result in the
revocation of the permit, and at the District's sole discretion, the removal of the crossing,
connection, or use. If dewatering is proposed, the permittee shall furnish a copy of the proposed
dewatering plan to this District prior to the start of construction.
9. The permittee may need to provide a stand by pump for bypassing the canal flow over the
temporarily closed canal crossing. However, in the event of forecasted landfall of a named storm
event, the permittee shall be prepared to provide additional pumping capabilities or reopen the
canal crossing so that the historical canal flow can be maintained. The permittee shall coordinate
with the District Superintendent of Works to assess if, or when, bypass pumping is necessary.
10. The permittee shall ensure that the project complies with current State Water Quality Standards.
The permittee shall be responsible for installing and maintaining measures to .prevent
sedimentation and turbidity issues within District canals. At a minimum, the Board recommends
installing turbidity curtains downstream of the construction site and installing silt fence as
applicable. The contractor shall stake all turbidity barriers at the canal high water line at minimum.
Please be advised that the contractor will need to coordinate with the District Supervisor or Works
as necessary for the removal of any turbidity barriers in the event of forecasted landfall of a
named storm event
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