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INDIAN RIVER FARMS WATER CONTROL DISTRICT <br />7305 4th Street <br />Vero Beach, Florida 32968 <br />(772) 562-2141 <br />APPLICATION FOR CONNECTION TO OR USE OF DISTRICT FACILITIES <br />No. 14 -14- <br />I Le: J U t J - 1(0, 2014 <br />A. Applicant Information: Name: 11--.11:71A1,1 Ra V Ems_ C.oU hIT"/ <br />Address: I PS01 277 714 .ST <br />�ZR Coe, <br />Authorized Agent and Title: Nl I -1-14 F -t- 7. r I fJ Rol WAS/ Pio DJC_T7or4 <br />nnphlA <br />Telephone Number: `7`7Z 18 <br />- ZZIp- 1�Cv C7E12-- <br />tow <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 />0 Pump connection to District canal for irrigation or drainage <br />Culvert and/or control structure in District canal for crossing <br />and/or water storage <br />0 Other (specify) <br />$300.00 <br />$100.00 <br />Location: Tract t`1/A , Section 2 I1 , Township 335 , Range , Canal No. LATS- -e <br />Other appropriate description: 2-oT1-1 ate/_ . 4,-7/4 ST. I, 1TF " � ' l NJ <br />+.. Property I.D. Parcel No.: rJ/A. <br />Attach drawing to show details (include acreage to be served). <br />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 />za I N • Arlr7 14011-t ST ItJTT So1.1 IiNnPRDVI✓ , Goal ST2ULT <br />tJr; V Cfl' KCo' SQX. ANSoLrn-% vF I�17?= - <br />S��TION1 La -ID WNSTrL)C. ',le -Ai,/ lo - ' I � LJLV —T pND Dv-i,_U-.- <br />IMP <br />To 71_1E.r. c RTF 1 2F IN1Truest=LTlowl• PcTI-1 4tT-vJ tSoX GUt,\/r=tZ-1-S <br />714 <br />E. Special Conditions: (for District use only) W �' �J'`lC� Tom <br />t�X_I STI N C� tax <br />SFr:- A i r/1�l!E.D LIST 07= C[71-)Dii'/v.vS <br />F. Estimated Date of Construction Commericernent: nJ, n D! 1- 1 I , 7 c 1 <br />Estimated Date of Construction Completion: S GnA E_ 1, Zo I S <br />Y!' 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 <br />Reverse hereof) <br />ned: <br />Applicant <br />Date G "•7"i `/ <br />Application approved by: <br />yrplication approved by: <br />(For District Use Only) <br />the s River Fa'ater Control District <br />I to of approval: a" Z'- <br />I,rpiration Date of this approved application: <br />PERMISSION, WHEN GRANTED, WILL BE SUBJECT TO THE STANDARD PROVISOS <br />SET FORTH ON THE REVERSE HEREOF. <br />9- ' -.)5 <br />Carter Associates, Inc., Engineer for District <br />