HomeMy WebLinkAbout93-3583
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N ~
_358:tP
Date / p -<9/ -7"3
BUILDING ELECTRICAL c~
:::::;,~,:~e3~Jy: igr::1/~
MECHANICAL
Sewer Conn
Water Conn:
~
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning: Energy Code:
-. 1/ "7 / //./
Description of Work --5 ~ j --r ('
Radon Gas:
FINAL
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Valuation or
Contract Price
~A-
br~
,
Pe,mit Fee ~
S;gnatu<e vf,. "7 _ _ '7L.uU~
Company
Address
City License Registration #
State Certified License#
Telephone# gJ ~
~79-3~pr
.~f!~'~
,:;/' CH'.LA.--J ~.J A O.A~
PLUMBING
MECHANICAL
BUILDING
ELECTRICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.001 shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
...."""'--~~:~#~~~'!'*'
APPLICATION TO CONSTRUCT, REPAIR, MODIFY OR ABANDON WELL
SOUTHWEST FLORIDA
WATER MANAGEMENT DISTRICT
2379 Broad Street, Brooksville, Fi 34609-6899 Ph: (904) 796-7211
~4
, "
Ie ~I. 0 I
Permit No.
StiPUI~
WUP Application No,
..,17-524 Well
-yll/ t/ 7 tr
Owner No.
AB()'vt lltl' IIrJt F(Jn OFFlC:IAL LJSf (HH 'y
'~. ,/ c.)1' c' ,
(, ( ) (r (C. " . . i
'.' .;., .~ -, ", l
Owner, legal Name ot Enli1y It Corpora
.-; -IS ~; ',l ) h ~\ \ (,-, \ r., t '.~
Well location - Address, Road Name or Number, City, Zip
.-'10\1(' n( ., "\ .
c,j\ - t <:" '.)''0/. ", f/{ ~ )5. itve 61(/ .IJ,,'1-)', -;;,! n I
..... Address ,.' \ fity. ZIp Telephone Number
C) 'J(" \- ;;U \ ) n I I Y }" ~ i.( "3 ~ \'. 'i C
1.
2.
r'-""-
3.
'..).L.
Drilling Contractor
v ( ({ .,
,/
1'0.
") ..;,..
if
,,!~
H.
iSf
Iii
H
Address
<';\} ") 'I( I .:+(
., I
City
4. Number of Wells:
_ Domestic
_ Public Water Supply
_ Recovery
5. Application for:
....:i...... New Cons1ruction
_ Repair/Modify
_ Abandonment
7. Method of Construction:
8.
County
L0( \ I
I
l-i t"\ c'
,
A-v~
13ro(
Ucen No.
'-=3-3 b I ((
State Zip
Check the Use of Well:
llrrigation
- Heat Pump/AeSupply
- Class V Heat Pump/AC Return
6. Casing ~,' or Liner _ (check one)
_ Black Steel
- Galvani~e.d
-1 PVC ,.
t- Rotary - eable Tool _ Combination _ Auger
_ Livestock
_ Industrial
- Class I Injection Well
- Test (WUP)
_ Monitor (type:
_ Other (
)
)
- Other (specify:
Seal Material:" r ...: 1J r
) ... 1/
'::;.
Diameter:
Subdivision Name
NW NE
9. Quarter Quarter Section ~ .5 'S (Indicate WelI0n Chart)
-
10. Section N Township ~ '\ Range ;l,,/
11. On 6-lnch Wells or Larger:
latitude
,
,
, 0 ,
---~----:----~---
, 0 ,
, 0 ,
, 0 ,
longitude
, , ,
- - - ~- - - -If - -~- ---
. . ,
, 0 ,
, . ,
SW SE
12. I hereby certify that I will comply with the rules of Chapter 40-9.:3,. florida Administrative Code, and that a
water use permit or artificial recharge permit, if needed, has ~n'or will be obtained prior to commence-
ment of well construction. I further certify that all information proVided on this application is accurate and
that I will obtain necessary approval from other federal, state, ("local governments, if applicable, I agree
to provr a well completion report to the District within 30, ~~,a/.ter drilling ope~tions cease.
I /'1. I <-..~ ~7 -) '- fi, {V. - I j 0 'J
Signature ot Contractor I ~se No.
- Other (specify'
Lot
Block
Unit
Drew a map of well/ocIItIon and Indlute ""-"-
IIIIiIh /III .X.. IdIIIItlfy /mown I'CMM and 1a1ld1rlarb:
prrwIda dIIIta-. ""'-" well and IandtnMlta.
North
<: J ni\, f,..' 4 '.-
'ii
~
1--
m
I
:'>1 6. ac..J
,.\'\ S ~j
South
^ i. i 0 \ \ ,r-, 'f
13. Is this well or any other well or water withdrawal on the owners'q,ontiguous property covered under a Water Use Permit (WUP) or WUP Application? _ Yes _ No
If Yes, provide WUP No. WeII/;D. No.
I certify that I am the owner of the property, that the inforl1UJ~,Pro..vided on well location is accurate, and that I am aware of my responsibilities under Chapter 373,
Florida Statutes, to maintain or properly abandon this weD;. Dr.V~Certity that I am (he agent for the 0WfI8{0 that the information provided is accurate, and that I have
informed the owner of his responsibilities as stated above. / /. ..l, ." _ /i "j I ! ({ "-
a.wn8r or Agent's Signature /
Granted By:
TIde: ~ ~-, ~ 4't-:A Date: I Q ,. IS - 'f';;
("' '/7--- -, 'j
Owner Number: Fee Received: $ 5-., CL Receipt No.: C. ( ..' Check No.:'" [L
THIS PERMIT NOT VALID UNTIL PROPERLY SIGNED BY AN OFFI6ER(!)F5WFWMD(R).IT SHALL BE AVAILABLE AT THE WELL SITE DURING ALL DRILLING OPERATIONS.
SF 306 (3) REV. 9192
a.'~~"".
WHITE: SWFWMD FilE COPY
YELLOW: DRilLING CONTRACTOR COPY/1
PINK: DRilliNG CONTRACTOR COPYI2
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
OWNER
JOB LOCATION
PARCEL I.D. #
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
, I
-- :::----..
L~ _______
FRONT PRO~NE
(
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR Rl, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E-
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 A'
FROR'l" PROPERTY LINE
FRONT PROPERTY LINE