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2012-186
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2012-186
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Entry Properties
Last modified
1/6/2016 10:51:37 AM
Creation date
10/1/2015 4:43:02 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
10/09/2012
Control Number
2012-186
Agenda Item Number
12.J.1
Entity Name
Jesse Roland and Catherine Michelle Barton-Roland
Jonathan Blake Gowen and Debbie Sue Gowen
Subject
Construction of Off-Site Utilities
Area
7760 92nd Court 7805 92nd Court
Supplemental fields
SmeadsoftID
11501
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NOTICE OF INTENT TO USE THE GENERAL PERMIT FOR CONSTRUCTION OF WATER MAIN <br /> EXTENSIONS FOR PWSs <br /> Proiect Name : 92nd Court Waterline Extension Permittee : N/A <br /> 2 . Explanation for Requirements Marked "X" in Part II . C . 1 Above, Including Justification, Documentation , Assurances, and/or <br /> Alternatives as Required by Rule for Exceptions to Requirements in Part II .C . 1 : 1 & in : No fire hydrants to be installed . <br /> ii-p : No air release valves : v : No known aggressive soils z: No stream crossings <br /> as & bb : No underwater crossings . dd: No heat exchangers . <br /> 1 completed Part Il of this notice, and the information provided in Part 11 and on the attachment(s) to Part 11 is true and <br /> accurate to the <br /> best of my knowledge and belief. <br /> Signature, Seal , and Date of Professional Engineer (PE) or Signature, Seal , and Date of Professional Engineer (PE) or <br /> Signature and Date of Other Person in Responsible Charge of Signature and Date of Other Person in Responsible Charge of <br /> Designing Project: * Designing Project: * <br /> `,000as� � ueone�e//,% <br /> �P *1 <br /> goes <br /> see <br /> Fs <br /> a - <br /> saw <br /> wAft <br /> 0 5313 Ado <br /> p <br /> see 0 aft "s <br /> APPJIM �•gas T • MVsewAM she400 sA.� ftV <br /> � <br /> P . <br /> Ale <br /> o� R . • ��� ,,a`� <br /> / 0 low <br /> Printed/Typed Name : Mr. Aaron J . Bowles, P.E . Printed/Typed Name : <br /> License Number of PE or License Number or Title of Other License Number of PE or License Number or Title of Other <br /> Person in Responsible Charge of Designing Project: * 55313 Person in Responsible Charge of Designing Project: * <br /> Portion of Preliminary Design Report for Which Responsible: Portion of Preliminary Design Report for Which Responsible: <br /> Entire Project <br /> * Except as noted in paragraphs 62-555. 520(3) (a) and (b), F. A. C. , projects shall be designed under the responsible charge of one or <br /> more PEs licensed in Florida. If this project is being designed under the responsible charge of one or more PEs licensed in <br /> Florida, Part 11 of this notice shall be completed, signed, sealed, and dated by the PE(s) in responsible charge. If this project <br /> is not <br /> being designed under the responsible charge of one or more PEs licensed in Florida, Part II shall be completed, signed, and dated <br /> by the person(s) in responsible charge of designing this project. <br /> DEP Form 6M55.9D0(7)A1lemate Page 6 <br /> Effective August 28, 2003 _, <br />
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