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HomeMy WebLinkAbout2007 Boudrot Dock Conversion to Public Pier�..�rrerarp .ter Management District Kirby B. Green III, Executive Director • David W. Fisk, Assistant Executive Director • Mike Slayton, Deputy Executive Director John Juilianna, Palm Bay Service Center Director, Regulatory 525 Community College Parkway S.E. • Palm Bay, FL 32909 (321) 984 -4940 �t�$ 9920��2 On the Internet at www.sjrwmd.com, December 18, 2007 2007 DEC City of Sebastian C/o Mr. Al Minner�, 1225 Main Street �f Sebastian, FL 32958 - ^. Re: Letter of Consent Boudrot Dock Conversion to the City of Sebastian Public Pier Application number 18- 061 - 40429 -3 (Please reference this number on all correspondence.) Dear Mr. Minner: Thank you for notifying the St. Johns River Water Management District of your intent to change the use of the Boudrot single - family dock to a public observation /fishing pier in the Indian River Lagoon, along your shoreline at 1302 Indian River Drive, Section 6, Township 31 South, Range 38 East, in Sebastian. The existing single - family dock totals 1030 square feet, 10 -feet of which is located landward of the mean high water line. To accommodate the proposed change in use from a single - family dock to a public observation/ fishing pier, "No Mooring" signs will be installed every 60 -feet along the length of the pier. In addition, a monofilament box will be installed at the pier's entrance. Staff has reviewed the information you provided and determined that the project qualifies for consent to use state -owned submerged lands. The District has based this determination upon the following: a) Sovereign submerged lands authorization was issued by the Department of Natural Resources on July 18, 1990 for the Boudrot single - family dock. b) The observation /fishing pier is open to the public. And; c) The 1,020 square foot observation /fishing pier does not cumulatively preempt more than 10 square feet of sovereignty submerged land for each linear foot of the applicant's shoreline. These construction details are consistent with the provisions of Sections 18- 20.004(5)(x) 4,5, 18- 20.004(5)(b), 18- 21(1)(c)2., F.A.C.10314. GOVERNING BOARD David G. Graham, CHAIRMAN Susan N. Hughes, VICE CHAIRMAN Ann T. Moore. SECRETARY W. Leonard Wood, TREASURER JACKSONVILLE PONTE VEDR.A BUNNELL FERNANDINA BEACH Michael Ertel Hersey "Herky' Huffman Arlen N. Jumper William W. Kerr Duane L. Ottenstroer OVIEDO ENTERPRISE FORT McCOY MELBOURNE BEACH JACKSONVILLE Providing your facility is consistent with the above, please consider this the authority sought under Section 253.77, Florida Statutes, and Chapter 18 -21, Florida Administrative Code, to pursue this project. Prior to commencement of construction and /or activities authorized herein, you must obtain the U.S. Army Corps of Engineers (ACOE) permit if required by the ACOE. Any modification to the construction and /or activities authorized herein that may be required by the ACOE shall require reconsideration by and the prior written approval of the St. Johns River Water Management prior to commencement of construction and /or any activities on sovereignty, submerged lands. This letter of consent in no way waives the authority and /or jurisdiction of any government entity, nor does it disclaim any title interest the state may have in the project site. Please check with your local government for specific requirements. Where local governments have standards, the more stringent standards shall apply. This letter does not constitute authority to proceed with your project under Chapter 373, F.S. Please retain this letter, as it constitutes consent to use sovereign submerged lands by the St. Johns River Water Management District. Please be aware that you are bound to the conditions set forth in the attached "General Consent Conditions ". Your pier may be inspected by authorized state personnel in the future to insure compliance with appropriate statutes and administrative codes. If your pier is not in compliance, you may be subject to penalties under Chapter 18 -14, F.A.C. If you have questions, please contact me at 321 - 984 -4940. Sincerely, d� John Juilianna, Director Palm Bay Service Center Enclosures: General Consent Conditions Notice of Rights cc: PDS -SSL Jaime Zsiros Joseph W. Schulke, P.E. - Schulke, Bittle, & Stoddard, LLC 1717 Indian River Blvd., Suite 201 Vero Beach, FL 32960 ST. JOHNS RIVER WATER MANAGEMENT DISTRICT SUBMERGED LANDS & ENVIRONMENTAL RESOURCES PROGRAM GENERAL CONSENT CONDITIONS Project No. 18- 061 - 40429 -3 • No activities other than those set forth in the attached letter dated December 2007, are authorized. Any additional activities on state -owned sovereignty 17, submerged lands must receive further consent from the Governor and Cabinet sitting as the Board of Trustees of the Internal Improvement Trust Fund (hereinafter the "Board ") or their properly designated agent. 2• Grantee agrees that all title and interest to all lands lying below the historical mean high water line or ordinary high water line are vested in the Board, and shall make no claim of title or interest in said lands by reason of the Occupancy use thereof. p y or 3• Grantee agrees to use or occupy the subject premises for those ur specified herein, and Grantee shall not permit the premises or any p p rt th ereof art th be used or occupied for any other purpose or knowingly permit ereof to nuisances or illegal operations of any kind on the premises. or suffer any 4. Grantee agrees to maintain the premises in good condition in the interest Public health, safety and welfare. The premises are subject to inspection bf th Board or its designated agent at any reasonable time. y e 5. Grantee agrees to indemnify, defend and hold harmless the Board and the of Florida from all claims, actions, lawsuits and demands arising out of this State consent. 6. No failure, or successive failures, on the part of the Board to enforce an Provision, waiver or successive waivers on the part of the Board of any yrovisio n herein, shall operate as a discharge thereof or render the same inoperative or impair the right of the Board to enforce the same in the event of subsequent uent q 7. Grantee binds itself and its successors and assigns to abide by the provisions and conditions set forth herein. In the event Grantee fails or refuses to compl y with the provisions and conditions of this consent, the consent of use may be terminated by the Board after written notice to the Grantee. Upon receipt of notice, the Grantee shall have thirty (30) days in which to correct the viol such Failure to correct the violations within this period shall result in the automaton. revocation of this Letter of Consent. c 8. All costs, including attorneys' fees, incurred by the Board in enforcing the terms and conditions of this consent shall be paid by the Grantee. Grantee agrees to accept service by certified mail of any notice required by Chapter 18 -14, Florida Administrative Code, at the address shown on the attached Consent of Use letter and further agrees to notify the Board in writing of any change of address at least 10 days before the change becomes effective. 9. Grantee agrees to assume responsibility for all liabilities that accrue to the sovereignty submerged land or to the improvements thereon, including any and all drainage or special assessments or taxes of every kind and description which are now or may be lawfully assessed and levied against the property during the effective period of this consent. 10. Grantee agrees that any dispute arising from matters relating to this consent shall be governed by the laws of Florida. 11. The Letter of Consent associated with these General consent conditions as well as these conditions themselves are subject to modification after 5 years in order to reflect any applicable changes in statutes, rule or policies of the Board or its designated agent. 12. In the event that any part of the structure(s) consented to herein is determined by a final adjudication issued by a court of competent jurisdiction to encroach on or interfere with adjacent riparian rights, Grantee agrees to either obtain written consent for the offending structure from the affected riparian owner or to remove the interference or encroachment within 60 days from the date of the adjudication. Failure to comply shall constitute a material breach of this consent and shall be grounds for its immediate termination. NOTICE OF RIGHTS A person whose substantial interests are or may be determined has the right to request an administrative hearing by filing a written petition with the St. Johns River Water Management District (District), or may choose to pursue mediation as an alternative remedy under Sections 120.569 and 120.573, Florida Statutes, before the deadline for filing a petition. Choosing mediation will not adversely affect the rights to a hearing if mediation does not result in a settlement. The procedures for pursuing mediation are set forth in Sections 120.569 and 120.57, Florida Statutes, and Rules 28- 106.111 and 28- 106.401 -.405, Florida Administrative Code. Pursuant to Chapter 28 -106 and Rule 40C- 1.1007, Florida Administrative Code, the petition must be filed at the office of the District Clerk at District Headquarters, P. O. Box 1429 Palatka, Florida 32178 -1429 (4049 Reid St., Palatka, FL 32177) within twenty -six (26) days of the District depositing notice of District decision in the mail (for those persons to whom the District mails actual notice) or within twenty -one (21) days of newspaper publication of the notice of District decision (for those persons to whom the District does not mail actual notice). A petition must comply with Chapter 28 -106, Florida Administrative Code. 2. If the Governing Board takes action which substantially differs from the notice of District decision, a person whose substantial interests are or may be determined has the right to request an administrative hearing or may choose to pursue mediation as an alternative remedy as described above. Pursuant to District Rule 40C- 1.1007, Florida Administrative Code, the petition must be filed at the office of the District Clerk at the address described above, within twenty -six (26) days of the District depositing notice of final District decision in the mail (for those persons to whom the District mails actual notice) or within fourteen (14) days of newspaper publication of the notice of its final agency action (for those persons to whom the District does not mail actual notice). Such a petition must comply with Rule Chapter 28 -106, Florida Administrative Code. 3. A substantially interested person has the right to a formal administrative hearing pursuant to Sections 120.569 and 120.57(1), Florida Statutes, where there is a dispute between the District and the party regarding an issue of material fact. A petition for formal hearing must comply with the requirements set forth in Rule 28- 106.201, Florida Administrative Code. 4. A substantially interested person has the right to an informal hearing pursuant to Sections 120.569 and 120.57(2), Florida Statutes, where no material facts are in dispute. A petition for an informal hearing must comply with the requirements set forth in Rule 28- 106.301, Florida Administrative Code, 5. A petition for an administrative hearing is deemed filed upon delivery of the petition to the District Clerk at the District Headquarters in Palatka, Florida. 6. Failure to file a petition for an administrative hearing, within the requisite time frame shall constitute a waiver of the right to an administrative hearing (Section 28- 106.111, Florida Administrative Code). 7. The right to an administrative hearing and the relevant procedures to be followed are governed by Chapter 120, Florida Statutes, and Chapter 28 -106, Florida Administrative Code, and Section 40C- 1.1007, Florida Administrative Code. 8. An applicant with a legal or equitable interest in real property who believes that a District permitting action is unreasonable or will unfairly burden the use of his property, has the right to, within 30 days of receipt of notice of the District's written decision regarding a permit application, apply for a special master proceeding under Section 70.51, Florida Statutes, by filing a written request for relief at the office of the District Clerk located at District headquarters, P. O. Box 1429, Palatka, FL 32178 -1429 (4049 Reid St., Palatka, FL 32177). A request for relief must contain the information listed in Subsection 70.51(6), Florida Statutes. 9. A timely filed request for relief under Section 70.51, Florida Statutes, tolls the time to request an administrative hearing under paragraph no. 1 or 2 above (Paragraph 70.51(10)(b), Florida Statutes). However, the filing of a request for an administrative hearing under paragraph no. 1 or 2 above waives the right to a special master proceeding (Subsection 70.51(10)(b), Florida Statutes). 10. Failure to file a request for relief within the requisite time frame shall constitute a waiver of the right to a special master proceeding (Subsection 70.51(3), Florida Statutes). 11. Any substantially affected person who claims that final action of the District constitutes an unconstitutional taking of property without just compensation may seek review of the action in circuit court pursuant to Section 373.617, Florida Statutes, and the Florida Rules of Civil Procedures, by filing an action in circuit court within 90 days of rendering of the final District action, (Section 373.617, Florida Statutes). 12. Pursuant to Section 120.68, Florida Statutes, a person who is adversely affected by final District action may seek review of the action in the District Court of Appeal by filing a notice of appeal pursuant to the Florida Rules of Appellate Procedure within 30 days of the rendering of the final District action. 13. A party to the proceeding before the District who claims that a District order is inconsistent with the provisions and purposes of Chapter 373, Florida Statutes, may seek review of the order pursuant to Section 373.114, Florida Statutes, by the Florida Land and Water Adjudicatory Commission, by filing a request for review with the Commission and serving a copy on the Department of Environmental Protection and any person named in the order within 20 days of adoption of a rule or the rendering of the District order. 14. For appeals to the District Courts of Appeal, a District action is considered rendered after it is signed on behalf of the District, and is filed by the District Clerk. 15. Failure to observe the relevant time frames for filing a petition for judicial review described in paragraphs #11 and #12, or for Commission review as described in paragraph #13, will result in waiver of that right to review. CERTIFICATE OF SERVICE I hereby certify that copy of the foregoing notice of rights has been sent by U.S. Mail to: City of Sebastian C/o Mr. Al Minner 1225 Main Street Sebastian, FL 32958 at 4:00 p.m. this December 18, 2007 LJ for Permit Data Services Gloria Jean Lewis, Director, St. Johns River Water Management District Post Office Box 1429 Palatka, FL 32178 -1429 (904) 329 -4500 Permit # 18- 061 - 40429 -3 W OWater Manacrement District Kirby B. Green IIL. Executive Director • David W. Fisk, Assistant Executive Director • Mike Slayton, Deputy Executive Director John Juilianna. Palm Bay Service Center Director, Regulatory 525 Community College Parkway S.E. • Palm Bay, FL 32909 • (321) 984 -4940 On the Internet at www.sjrwmd.com, Dear Permittee: The District issued the enclosed permit. We would like to offer our assistance to insure that your project is constructed in accordance with the district permit. We will be glad to arrange for a representative from this office to attend any preconstruction meeting that you may schedule for this project. For planning purposes, we ask that you give us at least 10 days notice prior to the scheduled meeting. This will enable us to gather all necessary information regarding your permit. If no other preconstruction meeting is scheduled, you may arrange a separate meeting with only District staff. On permits where mitigation is proposed, the permittee is required by condition to schedule a meeting with District staff. Therefore, please check your permit conditions to determine whether or not a preconstruction meeting is required. Please feel free to call Karen Boles at (321) 676 -6616 to notify us of your preconstruction meetings, or to arrange a meeting with District staff. cc: File copy Consultant PDS -CI GOVERNING BOARD David G. Graham, CHAIRMAN Ann T Moore. SECRETARY Duane L. Ottenstroer, TREASURER Susan N. Hughes JACKSONVILLE BUNNELL JACKSONVILLE PONTE VEDRA. Michael Ertel Hersey "Herky" Huffman Arlen N. Jumper William W. Kerr W. Leonard Wood OVIEDO ENTERPRISE FORT McCOY MELBOURNE BEACH FERNANDINA BEACH 4049 Reid Street - P.O. Box 1429 - Palatka, FL 32178 -1429 - (386) 329 -4500 On the Internet at www.sjrwmd.com, Holders of General State Submerged Lands Permits Dear Permittee: Please be advised that the District has not published a notice in the newspaper advising the public that it is issuing a permit for this proposed project. Publication, using the District form, notifies members of the public (third parties) of their rights to challenge the issuance of the permit. If proper notice is given by publication, third parties have a 14 -day time limit on the time they have to file a petition opposing the issuance of the permit. To confirm the period for filing such a challenge is closed, you may publish (at your own expense) a notice in a newspaper of general circulation within the affected area. If you do not publish, a person's right to challenge the issuance of the general permit extends for an indefinite period of time. A copy of the form of the notice and a list of newspapers of general circulation commonly used by the District is attached for your use. However, you do not have to use only those newspapers listed and this publication need only appear once. When the notice is published, the newspaper will return to you an affidavit as proof of publication. To complete your file with the District, submit this original affidavit of publication to: Gloria Lewis, Director Division of Permit Data Services P. O. Box 1429 Palatka, FL 32178 -1429 (386) 329 -4235 Enclosed is a sample package used for newspaper noticing by the District. Particular attention should be given to Pages 2 and 3 for successful completion of the newspaper noticing process. If I can be of further assistance, please contact Shannon Barican at (386) 329 -4266 or Quenteria Johnson at (386) 329 - 44349. Sincerely, M, 1�1 W Gloria Lewis, Director Division of Permit Data Services GOVERNING QCiARD David G. Graham, CHAIRMAN Ann T. Moore, SECRETARY Duane L. Ottenstroer, TREASURER JACKSONVILLE BUNNELL JACKSONVILLE Michael Ertel Hersey "Herky" Huffman Arlen N, Jumper William W. Kerr OVIEDO ENTERPRISE FORT McCOY MELBOURNE BEACH Susan N. Hughes PONTE VEDRA W, Leonard Wood FERNANDINA BEACH NOTICE OF AGENCY ACTION TAKEN BY THE ST. JOHNS RIVER WATER MANAGEMENT DISTRICT Notice is given that the following permit was issued on (Name and address of applicant) permit # I . The project is located in County, Section , Township South, Range East. The permit authorizes A SURFACE WATER MANAGEMENT SYSTEM ON ACRES TO SERVE known as The receiving water body is The file(s) containing the application for the above listed permit is available for inspection Monday through Friday except for legal holidays, 8:00 a.m. to 5:00 p.m. at the St. Johns River Water Management District (District) Headquarters, 4049 Reid Street, Palatka, FL 32178 -1429. A person whose substantial interests are affected by the District permitting decision may petition for an administrative hearing in accordance with sections 120.569 and 120.57, Florida Statutes, or may choose to pursue mediation as an alternative remedy under section 120.573, Florida Statutes, before the deadline for filing a petition. Choosing mediation will not adversely affect the right to a hearing if mediation does not result in a settlement. The procedures for pursuing mediation are set forth in section 120.573, Florida Statutes, and rules 28- 106.111 and 28- 106.401 -.404 Florida Administrative Code. Petitions must comply with the requirements of Florida Administrative Code Chapter 28 -106 and be filed with (received by) the District Clerk located at District Headquarters, Highway 100 West, Palatka, FL 32177. Petitions for administrative hearing on the above application(s) must be filed within twenty -one (21) days of publication of this notice or within twenty - six (26) days of the District depositing notice of this intent in the mail for those persons to whom the District mails actual notice. Failure to file a petition within this time period shall constitute a waiver of any right(s) such person(s) may have to request an administrative determination (hearing) under sections 120.569 and 120.57, F.S., concerning the subject permit. Petitions that are not filed in accordance with the above provisions are subject to dismissal. Because the administrative hearing process is designed to formulate final agency action, the filing of a petition means that the District's final action may be different from the position taken by it in this notice of intent. Persons whose substantial interests will be affected by any such final decision of the District on the applicant have the right to petition to become a party to the proceeding, in accordance with the requirements set forth above. Revised August 27, 2007 2 H: /pds /data/Holders of General Permits MEWSPAP.,ER IDI ER _]SING ALACHUA The Alachua County Record Legal Advertising P. 0. Box 806 Gainesville, FL 32602 352 - 377- 2444/fax 352 - 338 -1986 BAKER Baker County Press Legal Advertising P. 0. Box 598 Maclenny, FL 32063 904 - 259 - 2400 /fax 904 - 259 -6502 BRADFORD Bradford County Telegraph Legal Advertising P. 0. Drawer A Starke, FL 32901 904 - 964 - 6305 /fax 904 - 964 -8628 BREVARD Florida Today, Legal Advertising P. 0. Box 419000 Melbourne, FL 32941 -9000 321 - 242 - 3500 /fax 321 - 242 -6618 CLAY Clay Today, Legal Advertising 1560 Kinsley Ave., Suite 1 Orange Park, FL 32073 904 -264- 3200 /fax 904 - 269 -6958 DUVAL Florida Times Union Legal Advertising 1 Riverside Avenue Jacksonville, FL 32202 904 - 359- 4321/fax 904 - 359 -4180' FLAGLER Flagler Tribune, c/o News Journal P. 0. Box 2831 Daytona Beach, FL 32120 -2831 Revised August 27, 2007 H: /pds /data/Holders of General Pennits (386) 740 -4503 /fax (386) 736 -8972 INDIAN RIVER Vero Beach Press Journal Legal Advertising P. 0. Box 1268 Vero Beach, FL 32961 -1268 772 - 978- 2214/fax 772 - 978 -2340 LAKE Daily Commercial Legal Advertising P. 0. Drawer 490007 Leesburg, FL 34749 352 - 787 - 0902 /fax 352 - 365 -1951 MARION Ocala Star Banner, Legal Advertising 2121 SW 19`h Avenue Road Ocala, FL 34474 352 - 867 - 4010 /fax 352 - 867 -4126 NASSAU News - Leader, Legal Advertising P. 0. Box 766 Fernandina Beach, FL 32035 904 - 261- 3696/fax 904 - 261 -3698 OKEECHOBEE Okeechobee News Legal Advertising P. 0. Box 639 Okeechobee, FL 34973 -0639 863 - 763- 3134/fax 863- 763 -5901 ORANGE Sentinel Communications Legal Advertising 633 N. Orange Avenue Orlando, FL 32801 407 - 420 - 5160 /fax 407 - 420 -5011 OSCEOLA Little Sentinel Legal Advertising 633 N. Orange Avenue 3 Orlando, FL 32801 407 - 420 - 5160 /fax 407 - 420 -5011 POLK Lakeland Ledger Publishing Co. Legal Advertising P. 0. Box 408 Lakeland, FL 33802 863 - 802- 7355/fax 863 - 802 -7814 PUTNAM Palatka Daily News Legal Advertising P. 0. Box 777 Palatka, FL 32178 386 - 312 - 5200 /fax 386 - 312 -6664 ST. JOHNS St. Augustine Record Legal Advertising P. 0. Box 1630 St. Augustine, FL 32085 904 - 829- 6562/fax 904 - 819 -3559 SEMINOLE Seminole Herald Legal Advertising 300 North French Avenue Sanford, FL 32771 407 - 322- 2611/fax 407 - 323 -9408 VOL USIA News Journal Corporation Legal Advertising P. 0. Box 2831 Daytona Beach, FL 32120 -2831 (386) 740 -4503 /fax (386) 736 -8972 MSSW /STORMWATER AS -BUILT CERTIFICATION BY A REGISTERED PROFESSIONAL* PERMIT PROJECT NAME: INSPECTION DATE(S): FORM EN-45 40C4, F.A.C. 40C -42, F.A.C. I HEREBY CERTIFY THAT ALL COMPONENTS OF THIS STORMWATER MANAGEMENT SYSTEM HAVE BEEN BUILT SUBSTANTIALLY IN ACCORDANCE WITH THE APPROVED PLANS AND SPECIFICATIONS AND IS READY FOR INSPECTION. ANY SUBSTANTIAL DEVIATIONS (NOTED BELOW) FROM THE APPROVED PLANS AND SPECIFICATIONS WILL NOT PREVENT THE SYSTEM FROM FUNCTIONING IN COMPLIANCE WITH THE REQUIREMENTS OF CHAPTERS 40C4, 40C-41, OR 40C42, F.A.C. (AS APPLICABLE), WHEN PROPERLY MAINTAINED AND OPERATED. THESE DETERMINATIONS HAVE BEEN BASED UPON ON -SITE OBSERVATION OF THE SYSTEM CONDUCTED BY ME OR BY MY DESIGNEE UNDER MY DIRECT SUPERVISION AND /OR MY REVIEW OF AS -BUILT PLANS CERTIFIED BY A REGISTERED PROFESSIONAL OR LAND SURVEYOR LICENSED IN THE STATE OF FLORIDA. NAME (please print) COMPANY NAME COMPANY ADDRESS CITY, STATE, ZIP CODE TELEPHONE NUMBER SIGNATURE OF PROFESSIONAL FLORIDA REGISTRATION NUMBER DATE (Affix Seal) SUBSTANTIAL DEVIATIONS FROM THE APPROVED PLANS AND SPECIFICATIONS: (NOTE: ATTACH TWO COPIES OF AS -BUILT PLANS WHEN THERE ARE SUBSTANTIAL DEVIATIONS) WITHIN 30 DAYS OF INSPECTION OF THE SYSTEM, SUBMIT TWO COPIES OF THIS FORM TO: DIVISION OF PERMIT DATA SERVICES ST. JOHNS RIVER WATER MANAGEMENT DISTRICT P.O. BOX 1429 PALATKA, FL 32178 -1429 A REGISTERED PROFESSIONAL IS DEFINED IN SUBSECTION 40C- 42.021(1) AS "A PROFESSIONAL REGISTERED IN FLORIDA WITH THE NECESSARY EXPERTISE IN THE FIELDS OR HYDROLOGY, DRAINAGE, FLOOD CONTROL, EROSION AND SEDIMENT CONTROL, AND STORMWATER POLLUTION CONTROL TO DESIGN AND CERTIFY STORMWATER MANAGEMENT SYSTEMS ". EXAMPLES OF REGISTERED PROFESSIONALS MAY INCLUDE PROFESSIONAL ENGINEERS LICENSED UNDER CHAPTER 471, F.S., PROFESSIONAL LANDSCAPE ARCHITECTS LICENSED UNDER CHAPTER 481, F.S., AND PROFESSIONAL GEOLOGISTS LICENSED UNDER CHAPTER 492, F.S., WHO HAVE THE REFERENCED SKILLS. FORM 40C- 1.181(13) EFFECTIVE 3121/93 FORM EN-46 40C4, F.A.C. 40C41, F.A.C. 40C -40, F.A.C. MSSW STORMWATER REGISTERED PROFESSIONAL'S* INSPECTION REPORT PERMIT PROJECT NAME: INSPECTION DATE(S): INSPECTION RESULTS: (CHECK ONE) I HEREBY VERIFY THAT I OR MY DESIGNEE UNDER MY DIRECT SUPERVISION HAVE INSPECTED THE SYSTEM AT THE ABOVE REFERENCED PROJECT AND THAT THE SYSTEM APPEARS TO BE FUNCTIONING IN ACCORDANCE WITH THE REQUIREMENTS OF THE PERMIT AND CHAPTERS 40C4, 40C -41, OR 40C -42, F.A.C., (AS APPLICABLE). THE FOLLOWING NECESSARY MAINTENANCE WAS CONDUCTED: I HEREBY CERTIFY THAT I OR MY DESIGNEE UNDER MY DIRECT SUPERVISION HAVE INSPECTED THE SYSTEM AT THE ABOVE REFERENCED PROJECT AND THAT THE SYSTEM DOES NOT APPEAR TO BE FUNCTIONING IN ACCORDANCE WITH THE REQUIREMENTS OF THE PERMIT AND CHAPTERS 40C -4, 40C -41, OR 40C -42, F.A.C., (AS APPLICABLE). I HAVE INFORMED THE OPERATION AND MAINTENANCE ENTITY OF THE FOLLOWING: (A) THAT THE SYSTEM DOES NOT APPEAR TO BE FUNCTIONING PROPERLY, (B) THAT MAINTENANCE IS REQUIRED TO BRING THE SYSTEM INTO COMPLIANCE, AND (C) IF MAINTENANCE MEASURES ARE NOT ADEQUATE TO BRING THE SYSTEM INTO COMPLIANCE, THE SYSTEM MAY HAVE TO BE REPLACED OR AN ALTERNATIVE DESIGN CONSTRUCTED SUBSEQUENT TO DISTRICTS' APPROVAL. NAME (please print) COMPANY NAME COMPANY ADDRESS CITY, STATE, ZIP CODE TELEPHONE NUMBER SIGNATURE OF PROFESSIONAL FLORIDA REGISTRATION NUMBER DATE (Affix Seal) WITHIN 30 DAYS OF COMPLETION OF THE SYSTEM, SUBMIT TWO COPIES OF THIS FORM TO: DEPARTMENT OF RESOURCE MANAGEMENT DIVISION OF PERMIT DATA SERVICES ST. JOHNS RIVER WATER MANAGEMENT DISTRICT P.O. BOX 1429 PALATKA, FL 32178 -1429 * A REGISTERED PROFESSIONAL IS DEFINED IN SUBSECTION 40C- 42.021(1) AS "A PROFESSIONAL REGISTERED IN FLORIDA WITH THE NECESSARY EXPERTISE IN THE FIELDS OR HYDROLOGY, DRAINAGE, FLOOD CONTROL, EROSION AND SEDIMENT CONTROL, AND STORMWATER POLLUTION CONTROL TO DESIGN AND CERTIFY STORMWATER MANAGEMENT SYSTEMS ". EXAMPLES OF REGISTERED PROFESSIONALS MAY INCLUDE PROFESSIONAL ENGINEERS LICENSED UNDER CHAPTER 471, F.S., PROFESSIONAL LANDSCAPE ARCHITECTS LICENSED UNDER CHAPTER 481, F.S., AND PROFESSIONAL GEOLOGISTS LICENSED UNDER CHAPTER 492, F.S., WHO HAVE THE REFERENCED SKILLS. FORM 40C- 1.181(15) EFFECTIVE 3/21/93 Permit Number: Project Name: _ Control Structure(s) St. Johns River Water Management District Annual Status Report for Surface Water Management System Construction (Required whenever construction duration exceeds one (1) year) St. Johns River Water Management District Post Office Box 1429 Palatka, FL 32178 -1429 Percent of Completion Benchmark Description (one per major control structure) Surface Water Management . Works Lake(s) Ditch(es) / Swale(s) Exfiltration Trench Dry Area(s) Berm(s) Print Name Permittee's or Authorized Agent's Signature H:1PDS\FORM S\EN -56. DOC form 40C- 4.900(4) Percent of Completion Phase: Date of Anticipated Completion Phone FORM EN - 56 Date of Completion Date of Anticipated Date of Completion Completion Title and Company Date Address ST. JOHNS RIVER WATER MANAGEMENT DISTRICT Construction Commencement Notice St. Johns River Water Management District Palm Bay Service Center 525 Community College Parkway, SE Palm Bay, FL 32909 PROJECT: PHASE: FORM EN - 57 I hereby notify the St. Johns River Water Management District that the construction of the surface water management system authorized by Environmental Resource Permit Number has commenced /is expected to commence on 199_, and will require a duration of approximately months weeks days to complete. It is understood that should the construction term extend beyond one year, I am obligated to submit the Annual Status Report for Surface Water Management System Construction for no. 40C4.900(4). PLEASE NOTE: If the actual construction commencement date is not know, District staff should be•so notified in writing in order to satisfy permit conditions. Permittee's or Authorized Agent's Telephone H: \PDS \FORMS \EN -57. DOC Form 40C- 4.900(3) Title and Company Address Date