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INDIAN RIVER FARMS WATER CONTROL DISTRICT <br />7305 4th Street <br />Vero Beach, Flokida 32968 <br />(772) 542-2141 ' <br />APPLICATION FOR CONNECTION TO. OR USE OF DISTRICT FACILITIES <br />Date: 07/29/2014 <br />A. Applicant Information: Name: Indi an River County <br />Address: 1801 27th Avenue <br />No. 14-15- <br />Vero <br />4 15 <br />Vero Beach, Florida 32960 <br />Authorized Agent and Title: ChristopherJ. Kfer, Jr., P.E. County Engineer <br />Telephone Number: 772-226-1221 <br />B. Proposed Connection or Use: (check appropriate box or boxes) NON-REFUNDABLE <br />O 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 />0 Other (specify) $100.00 <br />C. Location: Tract , Section 4,9 , Township 32S , Range 39E , Canal No. G <br />Other appropriate description: IRFWCD Later al G Canal et 69th Street <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 />Remove existing bridge on 69th Street at IRFWCD Lateral G Canal and rnplece with <br />90" RCP Culvert. Also 72" RCP Culvert proposed in IRFWCD Sublatersl 8-4 Canal. <br />E. Special Conditions: (for District use only) <br />Wit= Ai- L1s i Oi SPlft:iA Qa-"ai•ria1%-'S. <br />F. Estimated Date of Construction Commencement: November 15, 2014 <br />Estimated Date of Construction Completion: July 15, 2015 <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 ' ers Yrereo#) <br />Signe <br />Application approved by: <br />Application approved by: <br />former Associates, Inc., Engineer for District <br />Date of approval: A) z6- <br />Expiration Date of this approved application: �e - 5 <br />PERMISSION, WHEN GRANTED, WILL BE SUBJECT TO THE STANDARD PROVISOS. <br />SET FORTH ON THE REVERSE HEREOF. <br />