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INDIAN RIVER FARMS WAT1rR CONTROL DISTRICT <br />7305 Ah Street. <br />Vero Beach Florida 32968 <br />- (772) 562=21.41 <br />P' <br />ti-JULvi. A vim <br />D7o 2oo7 <br />Nov !" <br />A: Applicant Information. Name: 12C f6lZ12 of COQUEy C0KM'55l09FZ5 <br />Address: 18t1 -o 2.51*" Snpemt_-r <br />VrEQn B"EAre j4l PL 32960 <br />Authorized Agent and Title: 4A.MC ala&Llo Jig PE, %lcnoc. Vi 'Pkgsice:u; (Araearni!S) <br />Telephone Number: 561- b 9l -o7aoo <br />B. Proposed Connection or Use: (check appropriate box or boxes) NON-REFUNDABLE <br />5d Culvert connection to District canal for irrigation -or drainage $100.00 <br />0 Pump connection to District canal for irrigation or drainage $300.00 <br />0 Culvert and/or control structure in District canal for crossing <br />and/or water storage $200.00 <br />9 Other (specify) _ _ _ _ _ $.100.00 <br />Sxnia <br />C. Location: Tract ,Section 2),-:2Z , Township 333 ,Range 39E ,Canal No. lZaLiEW <br />Other appropriate description: 43 l5'" ST, Sl�l /gf TPes6cTiod, INDIAN (Zyek CcwAgy <br />Property I.D. Parcel No.: <br />Attach drawing. to show details (include acreage to be served). <br />D:.:, Details of proposed Construction: (Give diameter and length of culvert; diameter and rated capacity <br />of pump; height and width of riser or other details on water control structure.) <br />kkoFa,l a4-n4lZea or ?urs AfPQ�Oes or ?Ne 431217ME 5"' ST S!J vnfr�sF.��orJ. Q 20-racT w�ce s� <br />kjiLL EE emoRdS TiZoeitO ALz*Jq{ 711E KXZr 51DE 01 43 A46, ANO R$JMOFF C0NJ6ye0 7a SourN Vt- . FF <br />4A JAL VIA f0(p Lr -18° ff-v� Iwo X11 Lr "j w p9j�' pumow A+omq .-roe. eAsr Laic. or 5'0 8r Sw cvuy eb <br />GCNdeVr=D -ro Q i. ^TccJZAL OP Sc TTII psueJ= 6h+J U VIAR (o r /F ' i84P4 .10, . <br />E. Special Conditions: (for District use only) I <br />5th A -WAGS <br />Li Si 15pcC/A• a. C7.ua r'a �Dz�S <br />E.' Estimated Date of Construction Commencement: /S,ucu5T I , 2C30-1 <br />Estimated Date of Construction Completion: Finew6l9i 1; 2608 <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 />Signed: <br />(Continued on Reverse hereof) <br />(nor District Use Only) <br />Application approved by: <br />Application approved by: <br />Date of approval: o r4?cT " <D7 `e� <br />Expiration Date of this approved application: C - Z S �o c8 <br />Date 5 <br />District <br />Associates, Inc., Engineer for District <br />PERMISSION, WHEN GRANTED,. WILL BE SUBJECT TO THE STANDARD PROVISOS. <br />SET FORTH ON THE REVERSE HEREOF <br />