HomeMy WebLinkAboutApplication Dewatering PermitCM OF
SEBASTMN
HOME OF PELICAN ISLAND
1225 Main Street, Sebastian, Florida 32958
Tel(772)589-5490 Fax(772)589-6209
ENGINEERING DEPARTMENT - APPLICANT INFORMATION SHEET
APPLICATION FOR PERMIT FOR DEWATERING IN THE CITY OF SEBASTIAN
This sheet is part of an application for permission to perform dewatering work within the City in
accordance with terms and conditions as set forth by the City Engineering Department.
ALL DEWATERING ACTIVITIES IN THE CITY REQUIRE A PERMIT
Name of Applicant: I
Address: _
Project Location Address:
Engineer of Record: _
Contact Numbers: C
Contractor Name and Adc
Contractor License / Registration: C 61 C- IIrJy07)(a12)
Location of Work:
4
This discharge water will impact and/or affect a :
Email:
Front Swale X Side Ditch_Rear Ditch / Channel _ Culvert Canal
Right of way=EasementOther:
Description of Work Involved:
I•
Does work require a St. Johns River Water Management District Permit ? Yesx_ No
If yes, attach the permit.
Attach Site map showing at a minimum the following:
a) Area to be dewatered;
b) Location of all turbidity barriers;
C) Type of turbidity barrier at each location; and,
d) General route of discharge and all poineff affs�1dise@rSiS NZ
y U
C:\Documents and Satlings:kjones`.N13 Document .Penui[s�Uli\i'.a'rERING Parmit-doe Aug 2001
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Description of each type of turbidity barrier to be used:
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Estimated Dates of Start/ Completion: i i 6s / 7- 1 0%
Hours of Dewatering Operations: )miw ire.
Estimated Volume to be Discharged: L i ht C� p I'UgZ� 1zl �� o l j �/
Conditions of Permit:
1. The permittee shall take turbidity readings a minimum of once each day at all points of
discharge into ditches, canals, swales, rivers, streams, or natural lakes. A log shall be kept on
site of all dewatering activites including but not limited to:
a. Name of person sampling.
b. Date and time sample taken.
c. Location of sample point.
d. Turbidity reading in NTU's
e. Date and time of turbidity barrier inspections.
f. Date, time and remedy of turbidity barrier breaches.
g. Person inspecting and/or repairing turbidity barrier.
2. Dewatering discharge must not cause or contribute to flooding of off-site properties
3. There shall be no direct discharges into Outstanding Florida Water (OFW), Class I or Class II
water bodies.
4. City authorized staff, upon proper identification, shall have permission to inspect and observe
dewatering operations in order to determine compliance with this permit
5. The permittee must mitigate any adverse impact caused by withdrawals permitted herein on
adjacent land uses or legal uses of water existing at the time of permit application.
Under penalty of perjury, I hereby
the statements set forth above are true.
•
Applicant Signature:
rj /VL-t,C
Engineering Use Only:
Pre -construction Inspection:
Final
C:'Docanneuts and Seuingslkjones-MY Documents TOrmits,DEWATERING Parmit.doc August 2005
r'_. N APPROVED
Date:
CITY OF SEBASTIAN
PUBLIC WORKSIENGINEERING 2540
RECEIPT
Date/� //1 � ❑ Cheekc, Y6
Amount Paid
001001208001 Sales Tax
001501 322050 Driveway Permft L , B , U
001501 322900 Street Opening Permit & Engineering Fees
680800 220301 Street Opening Security Deposit
001501341910 Zoning Map
001501341920 Copies
001501362100 Community Center Rent
001501362100 Yacht Club Rent
001501362150 Park Rent PavilionlElectdc
680800220681 Yacht Club Security Deposit
680800220682 Community Center Security Deposit
680800220683 erviewPark S Deposit
I Bali
Total Paid O ,
White - Dept. of Origin • Yellow- Finance • Pink Applicant