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INDIAN RIVER FARMS WATER CONTROL DISTRICT <br /> 4400 20th Street <br /> Vero Beach, Florida 32960 <br /> (772) 562m2141 <br /> APPLICATION FOR CONNECTION TO OR USE OF DISTRICT FACILITIES <br /> �Date : 2 / 9 / 05 No . <br /> A. Applicant Information : Name : Indian River county <br /> Address : 1840 25th Street <br /> Vero Beach , FL 32960- 3365 <br /> Authorized Agent and Title : Jim Davis , Public Works Director <br /> Telephone Number : 567 - 8000 <br /> B . Proposed Connection or Use : (check appropriate box or boxes) NON-REFUNDABLE <br /> ❑ Culvert connection to District canal for irrigation or drainage $ 100 . 00 <br /> ❑ Pump connection to District canal for irrigation or drainage $ 300 . 00 <br /> ❑ Culvert and/or control structure in District canal for crossing <br /> and/or water storage $ 200 . 00 <br /> ® Other (specify) Bridge - Culvert $ 100 . 00 <br /> C . Location : Tract Section 13 Township 33S Range 39E Canal No . <br /> Other appropriate description : Bridge replacement on Oslo Rd over Lateral J Canal <br /> Property I . D . Parcel No . : <br /> Attach drawing to show details ( include acreage to be served ) . <br /> D. Details of proposed Construction : (Give diameter and length of culvert ; diameter and rated capacity <br /> of pump ; height and width of riser or other details on water control structure . ) <br /> Replace existing vehicular bridge wite pre- cgst bridge culvert . <br /> E. Special Conditie >for District use only) <br /> F. Estimated Date of Construction Commencement : 5 / 1 / 05 <br /> Estimated Date of Construction Completion : 7 / 1 / 05 <br /> G. As the Applicant for permit, I do understand and agree that : <br /> 1 . The use of, or construction within , the right-of-way of the Indian River Farms Water Control District <br /> will be in accordance with the details of the approved sketch and/or permit conditions shown hereon, <br /> supporting this application ; and if any changes are required , same will be cleared with the District. <br /> (Continued on Reverse hereof) <br /> Signed : Date (� !I CSS <br /> Ap cant <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - <br /> (For District Use Only) <br /> Application approved by : <br /> for the Indian River Farms Water Control District <br /> Application approved by : <br /> for Carter Associates, Inc . , Engineer for District <br /> Date of approval : - <br /> Expiration Date of this approved application: <br /> PERMISSION , WHEN GRANTED, WILL BE SUBJECT TO THE STANDARD PROVISOS. <br /> SET FORTH ON THE REVERSE HEREOF, <br />