Laserfiche WebLink
INDIAN RIVER FARMS WATER CONTROLbISTRICT <br />7305 4th Street <br />Vero Beach, Florida 32968 <br />(772) 562-2141 <br />APPLICATION FOR CONNECTION TO OR USE OF DISTRICT FACILITIES <br />Date: April 17, 6W 1 `1 <br />A. Applicant Information: Name: (/U D / A it./ /Z t VCA, G O U/v 'ri <br />Address: /8 01 c27 S'772 -a8-7- ( gut 1-0 A) <br />/.L7 <br />No. 14 -07 <br />Authorized Agent and Title: /19/cA ai /c-2 9 , <br />Telephone Number: 7'7 . � -- / 7 6 <br />R(PpDP014.i P/ e L? ri at) <br />rt1R-•L�f?G-r=�L <br />B. Proposed Connection or Use: (check appropriate box or boxes) NON-REFUNDABLE <br />D Culvert connection to District canal for irrigation or drainage <br />❑ Pump connection to District canal for irrigation or drainage <br />C -Culvert and/or control structure in District canal for crossing <br />and/or water storage <br />$100.00 <br />$300.00 <br />❑ Other (specify) $100.00 <br />C. Location: Tract , Section o28/ , 7f Township �'�, S. , Range 3 y C , Canal No.- Q -- 53 <br />Other appropriate description: 't -i rJ7 e — /3 ST. 5 w <br />Property I.D. Parcel No.: )//4 <br />Attach drawing to show details (include acreage to be served). <br />1 RC Paz? f r'MO53o B <br />D. Details of proposed Construction: (Give diameter and length of culvert; diameter and rated capacity <br />of pump; height and width of riser or other details on water control structure.) <br />l3 5T2/ T 5w 41- 50 /ZI D(rL' IZ •PI-4CL !'IEL2q--- <br />12,0c1( <br />IZDc/( FZv s13Lc- <br />c,100'— 640 (2..LP , Lp.rr3-$ LJd (- GI L4 -T, 13 <br />'7'z' — o" RCP / 1-41- r Fid Lilt; & <br />E. Special Conditions: (for District use only) <br />F Estimated Date of Construction Commencement: / O / / L. <br />Estimated Date of Construction Completion: G — — 1 5 <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: f/ •,G!/ /7 X -c0- j <br />Applicant <br />Date 474._ / 7— / y' <br />Application approved by: <br />Application approved by: <br />(For District Use Only) <br />Date of approval: <br />Expiration Date of this approved application: ls-- z6 — 5— <br />u'2 <br />for Carter Associates, Inc., Engineer for District <br />Water Control District <br />PERMISSION, WHEN GRANTED, WILL BE SUBJECT TO THE STANDARD PROVISOS <br />SET FORTH ON THE REVERSE HEREOF. <br />