HomeMy WebLinkAbout2005 - Dewatering Applicationarc a
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HOME OF PELICANISLAND
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: INC
Address: l b t 15 E Nobe 5boAd P( .33 `i
Project Location Address: 1 U) � +r
Engineer of Record: G Nee I 5[ha er
Contact Numbers: Office Tel.:'1`I1-`10-L17D7Cell:112-N73 /Email: 5bpe n+na ntI'k a(�er,cenl
Contractor Name and Address: w, (6, ismL;�)n >=roc (Ma7- . Ccn+raLEor\
Contractor License / Registration:W ,1Z. rn n ZNL 13 I 5 a
5.�n1.ne t-n�+nee`In C. t��lil�C:O
Location of Work:
1 I SF_ `6� S1rPet o C� SIO
Ps1 r IR�r.[' I}
This discharge water will impact and/or affect a
Front Swale Side Ditch Rear Ditch /hannel
mCulvert _ C nal _
Right of wayEaseent_2S_Other: omen+ IJb+u�S k.�' Iitr Darr+'
Description of Work Involved: ff I�hII
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of ei'IIA:t CbnSir'oc�%orl
Does work require a St. Johns River Water Management District Permit ? Yes_J No_
If yes, attach the permit. CITY OF SEBASTIAN
ENGINEERING DEPARTMENT
Attach Site map showing at a minimum the following: 9RQU=PLAN APPROVED
a) Area to be dewatered; �s:i✓ „i e
b) Location of all turbidity barriers; 3 z s
C) Type of turbidity barrier at each location; and,
d) General route of discharge and all points of offsidi her e.
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Description of each type of turgidity barrier to be used:
Estimated Dates of Start /Completion: I � / 5-k S— / "% L dU
Hours of Dewatering Operations: Ry
Estimated Volume to be
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, 1
Applicant Signature:
Engineering Use Only:
Pre -construction Inspection:
Final
the statements set forth above are true.
C: Doorman, and Seuin,, kynV1 AIc Do:unr )lI P0 III Dl(\N %] F.RISG PCI'nlil duC Vt ni,i 200'
Date: I (,G J
Date:
CITY OF
PUBLIC NIORKSIENGMEE ING 2529
RECEIPT
Name/ •Q/&�(�J�� 0 Cash
Date `! , Yi Checkt / C 3
Amount Paid
001001208001 Sales Tax
001501 322050
Driveway Permft L , B J U
001501322900
Street Opening Permit & Engineering Fees
680800220301
Street Opening Security Deposit
001501 341910
Zoning Map
001501341920
Copies
001501362100
Community Center Rent
001501362100
Yacht Club Rent
001501 362150
Park Rent PavilionlEleclric
680800220681
Yacht Club Security Deposit
680800220682
Community Center Security Deposit
680800 220683
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Total Paid 260-
Initials
White - Dept of Origin• Yellow - Finance • Pink - Applicant