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HomeMy WebLinkAboutD O H WATER WELL PERMITS11 eBridge Web Viewer �; Page 1 of 5 r � Ron DeSantis Mission: Governor To protect, promote & improve the health of all people In Florida through Integrated3 41 state, county & community efforts. Scott A. Rivkees, MD ILI IJ State Surgeon General Vision: 7o be the Healthiest State In the Nation i Florida Department of Health in St. Lucie County Conditions for Issuance of Water Well Permits II Effective July 24, 2017 SCANNEDBY St Lucie County • 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 SLC DOH-WELLS(M-FLH EALTH. 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@FLHEALTH.GOV Submit revisions to permit and/or site map within 48 hours of well construction or abandonment. Florida Department of Health -St Lucle County Division of Disease Control and Health Protection Bureau of Environmental Health Locatlon: 3866 S US Hlghway1, Fort Pierce, FL 34982 Mailing: 5150 NW Milner Drive, Port St Lucie, FL 34983 Phone 772-873-4931 Fax 772-595-1306 Accredited Health Department • 1 Public Health Accreditation Board https:Hs2.ebridgie.com/ebridgel3.0/webviewerNiewer.aspx?ref=jgGE%2bHKLLJOIWMV7mUAKL 1 Wq... 12/11 /2019 eBridge Web Viewer f LA341 t t' l:IPCGQ ©� i Page 2 of 5 STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT, 5g.28983 REPAIR, MODIFY, OR ABANDON A WELL Permit No. . OSouthwast P OSL Johns River LEASEFILLOUTALLAPPLICABLEFiEL13S Florida UWque ID O Northwest ("Denotes Required Fields Where Applicable) Permit Stipulations Required (See Attached) 0South Florida Thu water woo confracforlsresponsible forcarnpleflnq rills form and forwarding file pemdt appUcation to file 62-524 Quad No. Delineation No. ❑Suwannee River appropriele dategaled authcvifyohere applicable, 13 DEP CUPMUPAppiication No. ❑Delegated Authority (If Applicable) ABOVE T�IS LINE -FOR OFFICIAL USE ONLY Avrler, If o o tion ess �CI IP •TelephoneNumber 2. e. el L - Addre s, Road Name Nu a Cily ^ 'Parcel IQ (PIN)orAlte a oy Ci aOne) I Lal Block Unit "Section or Land Grant 'Township nge TO o�rnty Su divi ion Check if 62-524: _Yes _ No 5. Walter Heer doh V 772 571-0324 whemdonwelisinc@aol,com `Water Well Contractor 'License Number 'Telephone Number E-mail Address 6. 134 Keystone Dr, Sebastian FL 32958 'Water Well Contractor's Address City State ZIP 7. °Type of Work: 7 Construction _Repair `Modification Abandonment S. "Number of Proposed Wells 1 TeasanrorRepalr, 11.004catlon.orAbandonment 9.'Spe* Intended Use(s) of Weti(s): d p LPM �D Domestic X Landscape Irrigation Agricultural Irrigation Silo Investigation --Bottled Water Supply ,Recreation Area Irrigation _Livestock _Monitoring —Public Water Supply (Limited Use/DOH) .Nursery Irrigation Test Public Water Supply (Community or Non-Community/DEP) Commarcialllnduslrial _Eerlh-Coupled Geothermal Class I Injection Golf Course Irrigation HVAC Supply OCT — J 201' HVAC Return Class V Injection: _Recharge �Commercialllndustrtal Disposal Aquifer Storage and Recovery _Drainage Remedlat on: _Recovery Air Sparge Other (0esaa,-) FDO . In otherMeembol � t u ie C illy Knit I LTH thole: Not a9xpec,�o+f Knlls are permitted bye given peimY,Ung eulhodlyj 10."Distance from Septic System if s200 - 11. Facfli sctipfion {> �� 12. Estmaled Start Date 13,"Estimated Well Depth r710 R. *Estimated Casing Depth kSLj 11. •Primary Casing Diameter �r in. Open Hole: From To. fL 14. Estimated Screen interval: FromITo ft. 15."Primary Casing Material: Black Steel Galvanized PVC Stainless Steel NotCased Other. 16. Secondary Casing: Teloscope Casing Liner Surface Casing Diameter in. 17. Secondary Casing Materiel 9fack Steel Galvanized PVC Stainless Steel Other 18.'Method of Construction, Repair. or Abandonment- Auger Cable Tool Jetted Rotary Sonic Combination (Two or More Methods) Hand Driven (Well Point, Sand Point) Hydraulic Point (Direct Push) —Horizontal Drilling Plugged by Approved Method other (DesaMol 19. Proposed Grouting Interval for the Primary, Secondary, and Additional Casing: From To Seal Material L_Bentonito Neat Cement Other ) From To Seat Material (_Bentonite Neat Cement Other ) From To Seal Material (__Bentonite ' Neat Cement Other ) From To Seal Material (__6entonile Neat Cement Other ) 20. Indicate total numberof existing wells on site List numberof existing unused wells on site 21 Tls thiswell crony existing wall orwaterIV waI an the owner's contiguous property covered undera Consumptive/Wa ter Use Permit (CUPNVUP) Wt1 or CUP/P Application? Yes ✓ No If yes, complete the following: CUPIWUP No. District Well ID No, 22. Latitude - Longitude 23. Data Obtained From: GPS Map __,survey Dalum: NAD 27 NAD 83 WGS 84 Me nNo:+rDyutm he■P +b'u ruW■otTdk da, F�arilnAJutr�trafvr Cosa aml suite water rccryN91:11 em Ne awneruua crmutr-vm�wernramdueonmanM�.......... ...... ,.,,...._ *License No. Signature of Own o_~'— .5 Approval Granted By f > issue Date %0 01-7 I . Expiration Date z-� HydrotogistAppreval Fee Received $ Receipt No. Check No. hllal THIS PERMIT IS NOT VALID UNTIL PROPERLYSiGNED BYAN AUTHORIZED OFFICER OR REPRESENTATIVE OF THE WMD ORDELEGATED AUTHORITY THE PERMIT SHALL SEAVAILABLEAT THE WELL SITE DURING ALL CONSTRUCTION. REPAIR, MODIFICATION, ORABANDONMENTACTIVITIES. 11��q DEP Fond: 62.532.900(1) Incorporatedin62S32A00(1),FA,C. Effective Date: October 7,20tO Page 1 of 2 /� https:Hs2.ebridge.com/ebridge/3.0/webviewerNiewer.aspx?ref=jgGE%2bHKLLJOIWMV7mUAKLl Wq... 12/11/2019 to 4-4 M 4] cal 03 a SIT III MP)1 OST 2 LOT 68 TOP OF FCRM ELEV.-tfi.o4 CBE ME PLAT NO, 1 " v p •• •� PROPCSFA CONC. PAD _ Lm 39.57 P.0. 55 PC. 12 .�i UNDER CCNSTRUCOON LOT 68 PROPOM MOM 4MR/D �IN ARE nTT SAW i P.FL-17.84 1 LvarErRr/Ir•txranEd4 t m � , © R0101ED COVERM 1 ENTRY 1` z� P141\ PCONCR FE. - .R. SAWW &AMCE oRRfE: v D ZOK w 3 a= N tlq 'd $ X a LOT 70 dos OSED FF,E.-17M .- 0 F37fSMr PLAT NO. 1 P,B. 59 PN, 12 = VACANTrs �J Q, M �U2 O O O m H M 7 �r r tau t, a � � :0 0 f0> U. z liar F1.COD avrrE � Lk:�� F1.Qo0 ZONE 1b: rAE Foy LQOAL DESCRIPTION BENC All, aF Urf 69. ACCORDING TO CRFtMCE PLAT NO. 1, AS RECORDETI N PLAT BaOK :ta. PACE 12 PUBLIC RECORDS aF 5T LUCIE Nmv,; Rt4A CONT11219 OLIO ACRM MORE aR LES& CRAPHO SCALE PROPI3ILSY ADDR588 io o io 8512 COEBIEME ORIM FORT PIERCE 4 wrtul per.. n a L IFIGME A. waoR�e,�ytwTloH1�S W fpp.Lpp�MrpmO prypt/Al eKtMfpAM� OR. Eaim OWAL IRrIIR] woo G . miOlO roasts lm aeadr Va. oD1310 3 r Em Cana mlrett Par. 0110OPOMILIlmllYr•samrt O9 m�leiO mNatI SM ow fft om1mmmiiRral[>soNno aws+nAaalORi Yerrol dos ml0m oleo P" oases eresstrAt uv trAoeral cB I1Io1D altlo BLOW Rah "I' m r aF e"LXW Grimm dl/0 rams aaw am Re, m m ONT Or aawllac E 011101151 cadet Lm RL MOM POW OF TAAaIkT OIL 1010" RAT rxt wtwloex vixomoairaannPtar •a gomm MshTm l awn TAM 101 0m lmrr OF MT 1110 mm wan Alp w s41. oaam s•mMr an"m umOm r®M . uL mreae usiln d lnlon L ap ensAPa Lnlaa eulc rA7rorcs Y+1Ta trMAlnatT Hoer mlpm WWM IIATA YA anpm EE7 wwo tlAA ATD as �1 A q*= oA7A aotaln eared wwlaMat w,WAadnwl u41d71T p,li. °oo�tfs erwyalA: • oaom aau0®ARM mm u VAL In fist d19X. Om'm ��mAcr oamp taAIU RW .dcWm r1GLTAl10Ai PAM Pose. oaom Pwena wa ttlMalR alAYA118S OBWZ AL NOTES 1. the lost data of field work was 130-07-1e 2. AdMriv or ddo9an to coveyg mope fir imports by Ogler Ulan the dTkO Pam' a W Is p parlrch7lllod wahwl edtton canters of We v1W2n2 VwV at poRhs 3. RS7rodadans of thin MOD era not VM eltlwnt IM dpnaturO and adpkol lOtred small of a FMda uemesdgwvaW and MOpper. 4. Lane Show+ hereon ware net otelmaled by M once for ttphte-or-wy, saremonh of rteoib eOnrehy, abendaamtaYe, dud ntlrIcU m. a Morph Act atl• Tkne Infmrntlen should be obWad thtouptl W mprtd o M wdR . 4 All abaft pmund flood Yapr mmmlR ow If W46 bbeen located Ono obtain hermn. 0. UA69WMC Nundatlom and bltpnswmd• rora net Imate0 as par! of Ude isr.* 7. Flood Note 0y moalh: pbiWp anir. lh4 pmp 4 lA Zane X and AE-149, aetaMnp to No Flood Imloonee _Rob MaoPP aienflwn y Pond Na 211IC0170 d, oMealhe date rWmwy -� wA Of D pofkcmg go ��oNmt„deehho bbeenn can ; (mm� There may ba �a wlidflon map s. Amon not L ft Flood Zone Ihn oham honan hoer been ubbYehed by the PLWAmd FIMA Pond and One a or esYtkp Mtd uloallan data. -. 0. The beahllgo shown below m based an Rat Imam illoa and an roloweed to Ilu Center Ike of Cobbles<au Odve ehteh ban Non 814P3t' Welt and all boodtnpo are TWO thrNa 10. NO Oaswneale ere shown hum other Dan shwa depfdsd a+ 0e ptaL fb search of the PAIJO need: has ban parramsd to fAd erflknot momrmb On t May odd. %'. 11. Qnoamle thown brews ere baud an the North Amrhan Vortical Caton 01.&V.a) f900. :: 12 Da bu0dkr aetbadu Show b�roen�Ot botad ee the Mot aedewle tMwenaUan, arw all !vr Site Osts 09/C7 auLperPEI L Temolgi.oNa, 1NC rtwweweoawvavow■ 10RTON °�"�'�°�" �WWPiMR7R.tHIN.Pn2L 1fb164rAT f16A Pif ...M, m2�, eBridge Web Viewer Page 4 of 5 Property Card Page 1 of 1 Michelle Franklin, CFA -- Saint Lucie County Property Appraiser — All rights reserved. Property Identification Site Address: 8612 Parcel ID: 2326-600-0074- Account #: 170566 Sec/Town/Range: Cobblestone DR 000-8 26/35S/39E Map ID: Zoning: Planned Un Use Type: 0000 Jurisdiction: Saint Lucie County ownership Legal Description D R Horton Inc CREEKSIDE PLAT NO. 1 (PB 55-12) LOT 69 (OR 3921- 1430 NE Culver DR 2362) Palm Bay, FL 32907 Current Values Historical Values 3-year Just/Market: $13,500 Assessed: $8,250 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $8,250 2019 $13,500 $8,250 $0 $8,250 2018 $7,500 $7,500 $0 $7,500 2017 $8,000 $8,000 $0 $8,000 Sale History Date Book/Page Sale Code Deed Grantor Price 10-07-2016 3921 / 2362 0205 SP Hoyer Homes at Creekside LLC $2,982,400 09-26-2014 3677 / 0599 0205 SP D R Horton Inc $2,290,000 11-29-2005 2427 / 1807 XX00 SP BJK LLC $21,900,000 Primary Building Information Finished Area of this building: 0 SF Gross Sketched Area: 0 SF View: Year Built: NIA Primary Wall: Bedrooms: 0 Full Baths: 0 Half Baths: 0 Exterior Data Roof Cover: Roof Structure: Building Type: Frame: Grade: Effective Year- NIA Story Height: No. Units: 0 Secondary Wall: Interior Data A/C %: 0% Electric: Primary Int Wall: Heated %: NIA% Heat Type: Avg Hgt/Floor: 0 Sprinkled %: 0% Heat Fuel: Primary Floors: Total Areas Finished/Under Air 0 (SF): Gross Sketched Area 0 Land Size (acres): 0.19 Land Size (SF): 8,451 Total Building Count: 1 Special Features and Yard Items Type Qty Units Year Bit • I All information is believed to be correct at this time, but is subject to change and is provided without any warranty. ® Copyright 2019 Saint Lucie County Property Appraiser, All rights reserved. https://paslc-dev.org/RECard/ I0/2/2019 https:Hs2.ebridge.com/ebridge/3.0/webviewerNiewer.aspx?ref=jgGE%2bHKLLJOIWMV7mUAKL1 Wq.l. 12/11/2019 eBridge Web Viewer - Page 5 of 5 St. Lucie County Health Department li'..IN 5150 NW Milner Dr Port Saint Lucie, FL 34983 i PAYING ON: #: siLL Doc a:56-BID-4429414 RECEIVED FROM: Walter Herndon Well Drilling AMOUNT PAID: $ 805.00 PAYMENT FORM: CREDIT CARD 057888 PAYMENT DATE: 1010112019 MAIL TO: Waiter Herndon Well Drilling Sebastian FL 32958 i FACILITY NAME: Walter Herndon Well Drilling I PROPERTY LOCATION: Sebastian FL 32958 Lot: Block: Property ID: EXPLANATION or DESCRIPTION: QUANTITY FEE -1 - Well Construction 7 $ 805.00 RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-4166312 Note: 7 Permits 59-29979-59-29986 I https://s2.ebridge.com/ebridge/3.0/webviewerNiewer.aspx?ref=jgGE%2bHKLLJOIWMV7mUAKL 1 Wq... 12/11 /2019