HomeMy WebLinkAboutDrainage Improvement Drawings
RULE 14-86.004, F.A.C. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-06
ROADWAY DESIGN
DRAINAGE CONNECTION PERMIT
10/08
Page 1 of 8
To be completed by DOT
2018-D-490-025
7/3/2018
Drainage Connection Permit No. Date
490
Felicia Thompson
Received By Maintenance Unit
5
State Road No. Work Program Project No.
010
Section No. Construction Project No.
20.000
Milepost Station
Instructions for Drainage Connection Permit
Pursuant to 14-86.004(6), F.A.C. “The Drainage Connection Permit form serves as the application. Once
approved by the Department, the form and supporting documents become the Drainage Connection Permit.”
The applicant shall submit four completed permit packages with original signatures. Each package shall include all
required attachments. All required signed and sealed plans and supporting documentation shall be submitted on no
larger than (11” X 17”) multipurpose paper, unless larger plan sheets are requested by the reviewer. The package will
include the following items. If an item does not apply to your project, indicate “Not Applicable” or “N/A.”
Included Part Title Completed by: Special Instructions
4
1 Permit Information Sheet Applicant
2 Certification by a Licensed Licensed Signed and Sealed
4
Professional Professional
4
3 Certification Applicant Signature
4 Owner’s Authorization of a Owner Signature
4
Representative
5 Affidavit of Ownership or Owner Signature
Control and Statement of
4
Contiguous Interest
4
6 Permit General Conditions FDOT
4
7 Permit Special Conditions FDOT
8 As-Built Certification Licensed Signed and Sealed – Submit within 15
Professional working days of completion of
construction
4
Attachment Legal Description
Attachment Photographs of Existing
Conditions
4
Attachment Location Map
4
Attachment Grading Plan
Attachment Soil Borings
Licensed
Signed and Sealed
Professional
Attachment Water Table / Percolation
4
Attachment Calculations
Attachment CD with Electronic Files of all Scanned Images in pdf format
Submittal Items
Note: Different Licensed Professionals may complete parts of the permit package. For example the Licensed
Professional signing and sealing the as-built certification may be different from the Licensed Professional who signed and
sealed the calculations for the permit package.
EXCEPTIONS:Activities that qualify for an Exception are listed in Rule 14-86, F.A.C. A permit application to the
Department is NOT required. However, if you desire verification whether the work qualifies for an exception, send a
completed copy of this permit package with its requested information to the applicable FDOT District Office.
Approved
2018-D-490-025
Olivia Bonilla
7/19/2018
RULE 14-86.004, F.A.C. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-06
ROADWAY DESIGN
DRAINAGE CONNECTION PERMIT
10/08
Page 2 of 8
PART 1 – Permit Information Sheet
4
Select one: Permit Exception
Pursuant to 14-86.002(2), F.A.C. “Applicant means the owner of the adjacent property or the owner’s authorized
representative.”
Applicant
4
Select one: Property Owner Owner’s Representative (Complete Part 4)
Paul Carlisle
Name:
City Manager, City Of Sebastian
Title and Company:
1225 Main Street
Address:
SebastianFlorida
32958
City: State: Zip:
(772) 388-8203 ext. ______
PCarlisle@cityofsebastian.org
Telephone: FAX: Email:
Property Owner (If not applicant)
Paul Carlisle
Name:
City Manager, City Of Sebastian
Title and Company:
1225 Main Street
Address:
32958
Florida
Sebastian
City: State: Zip:
(772) 388-8203 ext. ______
PCarlisle@cityofsebastian.org
Telephone: FAX: Email:
Applicant's Licensed Professional
55313
Aaron Bowles
Name: Florida License Number:
Professional Engineer, MBVEngineering, Inc
Title and Company:
1835 20th Street
Address:
Florida 32960
Vero Beach
City: State: Zip:
(772) 778-3617 ext. ______
(772) 569-0035 ext. ______
aaronb@mbveng.com
Telephone: FAX: Email:
Project Information:
Oyster Pointe Drainage Improvement
Project Name:
SR 5
Location:
STREET SR. NO. US HWY NO. CITY
010
Indian River
COUNTY SECTION(S) TOWNSHIP(S) RANGE(S)
27.8214517702977
-80.4722858753693
*Geographic Coordinates: Latitude (DMS.SSS): Longitude (DMS.SSS):
Horizontal Datum: (NAD 83 / Adj.)
0
0
* State Plane Coordinates: Northing Easting:
Projection Zone: Florida North Florida East Florida West
Coordinate shall be the center of the driveway intersection with FDOT R/W, or, if there is no driveway connection, near the cenFDOT R/W, or, if there is no driveway connection, near
the cenFDOT R/W, or, if there is no driveway connection, near the center of the ter of the ter of the
Approved
property line nearest the state highway.
2018-D-490-0252018-D-490-0252018-D-490-025
*Check with the FDOT Office for requirement.
Olivia BonillaOlivia Bonilla
7/19/2018
RULE 14-86.004, F.A.C. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-06
ROADWAY DESIGN
DRAINAGE CONNECTION PERMIT
10/08
Page 3 of 8
Brief description of facility and proposed connection:
The proposed project consists of the installation of a new storm ditch bottom inlet to combine multiple
storm water pipes currently out falling to an open ditch located along Indian River Drive.
Briefly describe why this activity requires a Drainage Connection Permit (Include where the stormwater will discharge to FDOT right of
way):
The proposed installation of a storm inlet will combine flows from FDOT US Highway 1 and Indian
River Drive, ultimately discharging to the Indian River Lagoon. These improvements are being
proposed to provide erosion control along Indian River Drive and adjacent private properties, and to
address public safety concerns with the open ditch.
Approved
2018-D-490-025
Olivia Bonilla
7/19/2018
RULE 14-86.004, F.A.C. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-06
ROADWAY DESIGN
DRAINAGE CONNECTION PERMIT
10/08
Page 6 of 8
PART 6 – Permit General Conditions
1. This permit is a license for permissive use only and does not convey any property rights either in real estate or
material, or any exclusive privilege and it does not authorize any injury to private property or invasion of private rights, or
any infringement of Federal, State or local laws, rules or regulations; nor does it obviate the necessity of obtaining any
required state or local approvals.
2. The drainage connection as authorized herein shall be constructed and thereafter maintained in accordance with the
documents attached hereto and incorporated by reference herein. All work performed in the Department's right of way
shall be done in accordance with the most current Department standards, specifications and the permit provisions. Such
construction shall be subject to the inspection and approval of the Department, and the Department may at any time make
such inspections as it deems necessary to assure that the drainage connection is in compliance with this permit.
3. The entire expense of construction within the Department right of way, including replacement of existing pavement or
other existing features, shall be borne by the permittee.
4. The permittee shall maintain that portion of the drainage connection authorized herein located on permittee’s property
in good condition. The Department shall maintain that portion of the drainage connection authorized herein located within
its right of way.
5. If the drainage connection is not constructed, operated or maintained in accordance with this permit, the permit may
be suspended or revoked. In this event modification or removal of any portion of the drainage connection from the
Department's right of way shall be at the permittee's expense.
6. The Department reserves the right to modify or remove the drainage connection to prevent damage or in conjunction
with road improvements.
7. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the
Department's right, title, and interest in the land to be entered upon and used by the permittee, and the permittee will, at
all times, assume all risk of and indemnify, defend and save harmless the Department from and against any and all loss,
damage, cost or expense arising in any manner on account of the exercise or attempted exercises by said permittee of
these rights and privileges, regardless of the respective degrees of fault of the parties.
8. Utilities, including gas lines, may exist within the right of way. Prior to beginning work the permittee shall contact
Sunshine State One Call of Florida, Inc at 811 or 800-432-4770, who will notify all utility owners near the scheduled
project. The utility owners have two (2) full business days to provide locations of their respective facilities. The permittee
shall be solely responsible for any damage to or conflicts with gas lines, utilities and/or third persons.
Treasure Coast Operations (Paul Brege)
9. The permittee shall notify the Department of Transportation Maintenance Office located at
(772) 429-4923 ext. ______
Phone 48 hours in advance of starting any work on the drainage connection
authorized by this permit and also 24 hours prior to any work within the Department’s right of way. Construction of any
365
work on the right of way shall be completed within days after such notification. If such construction is not
365
completed within days after such notification, the permittee shall notify the Department of the
anticipated completion date.
10. This permit shall expire if construction on the drainage connection is not begun within one year from the date of
7/19/2019
approval and if construction on the drainage connection is not completed by (Date) .
11.A permittee may request an extension of the Drainage Connection Permit expiration date by filing a written request
for a permit time extension. All requests for time extensions must be received by the Department 15 working days prior to
the expiration date.
12. All the provisions of this permit shall be binding on any assignee or successor in interest of the permittee.
ApprovedApproved
2018-D-490-025
Olivia Bonilla
7/19/2018
RULE 14-86.004, F.A.C. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-06
ROADWAY DESIGN
DRAINAGE CONNECTION PERMIT
10/08
Page 7 of 8
PART 7 – Permit Special Conditions – To be completed by FDOT
The above request has been reviewed and has been found to meet the regulations as prescribed in Rule 14-86, F.A.C.,
and is hereby approved, subject to the following special conditions:
There is an authorized drainage connection to FDOT right of way. This permit authorizes drainage
structures in the right of way.
This Drainage Connection Permit authorizes construction of the drainage structures shown in the
approved plans.
This Drainage Connection Permit does NOT authorize any other work inside FDOT right of way. Any
other work inside FDOT right of way must be authorized by another permit type such as an Access
Permit.
Department of Transportation:
Olivia Bonilla
Signature
ApprovedApproved
DRAINAGE DESIGNER III
7/19/2018
Title Date
2018-D-490-0252018-D-490-025
Olivia BonillaOlivia Bonilla
7/19/2018
RULE 14-86.004, F.A.C. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-06
ROADWAY DESIGN
DRAINAGE CONNECTION PERMIT
10/08
Page 8 of 8
PART 8 – As-Built Certification
Within 15 working days of completion of construction, you must send this certification to the Department office in which
you filed your DOT Drainage Permit.
1. STORM WATER FACILITY INFORMATION
Permit No.:
Source (Project) Name:
Source Location: Street
City: County:
Source Owner:
Owner Address:
2. AS-BUILT CERTIFICATION
I hereby certify that this storm water facility has been built substantially in accordance with the certified design plans, and
that any substantial deviations (noted below) will not prevent the facility from functioning in compliance with the
requirements of Chapter 14-86 F.A.C. when properly maintained and operated. These determinations have been based
upon on-site observation of construction, scheduled and conducted by me or by a project representative under my direct
supervision.
Name of Licensed Professional:
Florida License Number:
Company Name (if applicable):
Certificate of Authorization Number (if applicable):
Address:
City: State: Zip:
Telephone: Fax: Email:
Signature of Licensed Professional
Date
(Affix Seal)
Substantial deviations from the approved plans and specifications (attach additional sheets if required).
ApprovedApproved
2018-D-490-0252018-D-490-0252018-D-490-0252018-D-490-0252018-D-490-025
Olivia Bonilla
7/19/2018