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HomeMy WebLinkAbout10-10485 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 10485 BUILDING PERMIT Permit Number: 10485 Address: 5039 1ST ST Permit Type: WELL MONITORING ZEPHYRHILLS, FL. Class of Work: WELL MONITORING Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 10 26 - *21- 0010 - 12800 -009 Improv. Cost: 0.4U Date Issued: 6/03/2010 Name: MIRA ENTERPRISES Total Fees: --2 5553 BRADDOCK DR Amount Paid: " C 3 ZEPHYRHILLS, FL 33541 Date Paid: Phone: Work Desc: MONITORING WELL MW -13R) DEPTH OF 35 FT - REPLACEMENT- FEE WAIVED 1 .M P'ILLI `V. N aload tgi'Y L `I AL -.I1 7117424, REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections 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. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." 6 44g-- rir '4 ft, CONTRACT SIGNATURE PERMIT OFFI FR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER MAY /04/2009/MON 03:43 PM ZEPHY'RHILLS BUILDING FAX No, 813 - 780 - 0021 P. 001 /001 CITY OF ZEPHYRHILLS— BUILDING DEPARTMENT RIGHT -OF -WAY USE PERMIT DATE: 5°_1F10 l ! v_ AI 4 • PERMIT J 6 L46 No construction under ground or above ground of any facility shall be accomplished on any City Rights of Way without written approval from the City Building Department. My application' for approval of construction operations on any City owned Rights of Way shall furnish a detailed drawing showing the complete scope of the proposed work in triplicate to the office of the Building Official for approval prior to the commencement of any work. A copy of this permit Is to be • kept readily available at the site of the work at all times. , Sit' PARCEL ID #: 10 - 26) ^ 21 - �I o _ 12000 - 0090 CITY ROAD � _ t LOCATION (Legal Description): See ac Permission Is hereby granted to N 5 5 of fiado 6 'is" 4 ( 0 "m ' For the construction and maintenance of: • . One "i-io ,rfe .� G,, e /1 6i1'IW : '3, ') A5 • a 0491 o . 5 1- , /1-, . e(4) 6t C�n /. S . -de-7`, . Subject to the following conditions: ' 1. The construction and maintenance of such utility shall not interfere with the property and rights of a prior occupant. 2. All work shall be done in keeping with the standards of the City Streets Department and under the supervision of the City Building Official, who will be notified at least one day prior to commencement of construction. 3. All materials and equipment shall be subject to inspection by the City Building official. 4. During construction all safety regulations of the Department of Transportation shall be observed and the City shall be relieved of all responsiblllty • from damage of any nature arising from this permit. Subject to the same terms and conditions, the permit holder may take such safety measures, including placing and display of caution signs, as it may deem necessary In conduct of construction and maintenance work hereunder. It Is the responsibility of the permlttee to ? ??? 5. All private and all City properly shall be restored to its original condition as far as practical in the opinion of the,City Building Official. 8, AIL underground crossing installations shall be laid at such depth as may be specified by the City Building Official. 7. The sketch covering the details of this .Installation shall be made a part of this permit. This permit i5 granted with the understanding that the applicant has notified all other utility users In the area covered by the permit and takes full responsibility for any damage incurred by prior installations as a result of his operations in order that they may safe guard their Interests. 8. it is expressly stipulated that this permit Is a license for permissive use only and that the placing of facilities upon public property pursuant to this permit shall not operate to create or to vest any property right in said holder. . 5. Whenever the City decides to further exploit the City Rights of Way, any or all said poles, wires, pipes, cables, or other facilities and appurtenances authorized hereunder, shall be immediately removed from said Rights of Way, or reset or relocated thereon as required by the City Building Offlclat at the expense of the holder of this permit. • 10. The holder shall save and keep the City harmless from any and all damages, claims, or Injuries that may occur by reason of the construction, maintenance, and operation of said facility.. 11. The holder shall complete the requested work within days or this permit shall become null and void. In the event the work requested Is not completed upon the expiration date of this permit, the City shall have the right to complete such work and to charge the holder of the permit for all costs incurred In completed said work. 12. The holder shall post a cash or surety bond with the City Manager In the sum of $ dollars to guarantee performance of the obligations herein, and to guarantee maintenance of the right -of -way described herein for a period of one (1) year following completion of the requested Installation. In the event a surety bond is posted, the surety bond shall be made payable to the City and shall obligate the surety tc hold the City harmless in the event the holder of this permit should fall to meet any of its obligations hereunder. The bond shall also indemnify the City for all court costs and reasonable attorneys fees in the event.Iegal action is required to collect on said bond. SUBMITTED BY: Q� �� „0,— �Qe e ,/,,,, (PfiRM ITTEE) / � ��SS de)c �orsU �f• • • • Signature &Title � -. / '"O,J `mot Sc.' #S. r Address /1/ ii(e /Se La,�r a Si E /-1 4 / .3,310/`/ REVIEWED BY CITY OF ZEPHYRHILLS a • Utilities Supervisor –7 • �" Date �/ " 3 // ` • . Fublic Works t � = — —' Date, t. 4 '(t '' NO OPCIO CUTS • r f 7 • /;s IG rYYj ,L 1 ` lr : /.� Jot�rfr . C4�r A. \ s CITY OF.ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 7572 BUILDING PERMIT Permit Number: 7572 Address: 5039 1S ST Permit Type: WELL MONITORING ZEPHYRHILLS, FL. Class of Work: WELL MONITORING Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 10-26=21-0010-12800-009 Improv. Cost: Date Issued: Name: MIRA ENTERPRISES Total Fees: Address: 5553 BRADDOCK DR Amount Paid: ZEPHYRHILLS, FL 33541 Date Paid: Phone: Work Desc: MONITORING WELL MW -85 ALONG 1ST ST -FEE WAVIED • , . W G (J O fa - Sasa.,& Qt i 3 • • •j REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) wont not ready for Inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner. Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain flnandng, consult with your lender or an attorney before recording your notice of commencement." CONTRACTOR SIGNATURE PERMIT OFFI !rR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER • Jacqueline Boges To: Shane LeBlanc; Nathan Coleman; David Henderson; Rick Moore Subject: row signature needed Greetings Gentlemen, I placed in Shane box a ROW for signature for a well monitoring on 1 street from Handex Consulting & Remediation . Signatures are needed and returned for City manager and Building official signatures. Thank you Jackie Boges Code Support Specialist ext. 35 1 ; HANDEX CONSULTING & REMEDIATION, LLC May 10, 2010 City of Zephyrhills Building Department 5335 8 Street Zephyrhills, Florida 33542 Phone: 813- 780 -0020 RE: Right -of -Way Use Permit Request FDEP Facility: Amoco # 171 Address: 37959 State Road 54, Zephyrhills, Florida FDEP Facility ID #:51/8519737 FDEP Work Order #: 2010- 91- W89434 HCR Project #: 117949.017 To Whom It May Concern: The Florida Department of Environmental Protection (FDEP) has approved the installation, under the supervision of Handex Consulting & Remediation — Southeast LLC (HCR), of one monitoring well at the above referenced facility. Due to the location of this proposed monitoring well being in a Right -of -way (ROW) in the easement between Maine -ly New England Restaurant and 1 St., the installation of this well will require a City of Zephyrhills ROW Use Permit. This permit application along with the legal description of the location has been included as Attachment A. The proposed monitoring well (designated MW -13R) will serve as a replacement well to existing monitoring well MW -13. The existing well was constructed to a depth of twenty - nine (29) feet below land surface (ft bls) and serves as a monitoring point for the collection of groundwater samples for laboratory analysis. The integrity of the well has degraded since installation of the well in 2001 and is no longer of use. The existing well MW -13 will be drilled out and the replacement well MW -13R is going to be installed in the same location. A site plan indicating the well location and the approximate location of the ROW along 1 St is included in Attachment B. The well installation will be performed via hollow -stem auger drill rig and MW -13R will be constructed to a total depth of 35 ft bls with a screened interval of 15 to 35 ft bls. The well construction details of proposed monitoring well MW -13R have also been included in Attachment B. The newly installed well will be capped with a locking well plug, graded to surface level and set beneath a concrete 2 X 2 ft well pad with a steel manhole complete with a bolt -down cover. 111 Kelsey Lane, Suite E Tampa, Florida 33619 P: 813 -626 -4646 F: 813 - 626 -1898 www.handex.com • • Mr. Harold Ogelby — City of Zephyrhills Building Dept. ROW Use Permit Request Page 2 On May 5, 2010, HCR contacted Sunshine State One CaII of Florida (SSOC) for the notification of all utility providers in the area and was issued SSOC ticket number 125001859 for the location of any underground utility lines present in the area. Upon the City of Zephyrhills' review and issuance of the ROW permit, HCR will again contact SSOC to re- notify the utility providers and update any underground utility location markings (if necessary) before beginning work at the site. In the event that any utility provider in the area does not respond to the request, HCR will contact them directly to ensure the proper pre - drilling utility mark -out procedure has been followed. The documentation of the SSOC utility notification including a list of the utility providers in the area that have been notified has been included as Attachment C. All proper precautions will be taken in order to establish a safe work area during the activities. A perimeter will be established designating the work area utilizing traffic cones and caution tape, and men working signs will be displayed to indicate the presence of workers in the area. Copies of the Maintenance of Traffic (MOT) certificates held by the HCR Health and Safety Officer are included as Attachment D. All appropriate personal protection equipment will be donned by all personnel involved in the site activities. Custom Drilling Services Inc of Mulberry, Florida has been selected as the licensed drilling company to perform the well installation under the supervision of HCR personnel. The state contractor's license held by Custom Drilling and the tax ID information for both HCR and Custom Drilling have been included as Attachment E. If you have any questions concerning the proposed well installation activities or require any additional information for the permit application, please do not hesitate to contact the undersigned (813) 626 -4646, Extension 1129. Sincerely, HANDEX CONSULTING & REMEDIATION — SOUTHEAST LLC - remy He : Project Scientist HANDEX CONSULTING & REMEDIATION, LLC Page 2 ATTACHMENT A RIGHT -OF -WAY USE PERMIT APPLICATION ATTACHMENT D MOT CERTIFICATIONS c '�"' �� : , i ? : • .�` 4 � •,� r ` hy^• - �o =" ` •\ ; c . � . "' °''" �<•V. fi r ,� �` A - t� `fin ' 0f C , ! '^�tY '"� + \ A w aG' F 'e,. '. s i I► a., . .. rA �::. i I�r �: s/ Alt �. > �► A x t r A 1 ae ." 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',i t ? z r i7S t. , r r 1� ' 4 5 . ♦ }` { t �,�, +, { t r 1. f '� 1t: . ,t y \`.'f' r Z, t }7 ,; dr ° i ,r7.".• +• ji � } .'� �.`�� t l sS' Gi ' � ti; .�J �.' ` �• ••• . i1S � L: �� ��at11 • ATTACHMENT E CONTRACTOR'S LICENSE / TAX ID S outhwest Florida 2379 Broad Street, Brooksville, Florida 34604 -6899 r � (352) 796 -7211 or 1- 800 - 423 -1476 (FL only) Water Management District TDD only 1-800-231-6103 (FL only) On the Internet at: WaterMatters.org Alt Brood Bartow Servlco Office Levant* Service Office Sarasota Service Office Tampa Service Office urwo "' na y 170 Century Boulevard Suite 226 6750 Frultville Road 7601 Highway 301 North Bartow, Florida 33830-7700 3600 West Sovereign Path Sarasota, Florida 34240 -9711 Tampa, Florida 33637-6759 (863) 5341448 or Lecanto, Florida 34461 -8070 (941) 377-3722 or (813) 985 -7481 or 1- 800492 -7862 (FL only) (352) 527 -8131 1 -800- 320 -3503 (FL only) 1 - 836 - 0797 (FL only) Todd Pressman MICHAEL D. JOHNSON Chair, Pinellas 100 IUD ELLIS ROAD Ronald E. Oakley Vice Chair, Pasco MULBERRY FL 33860 Hugh M. 9ramilne Secretary, Hillsborough Sallie Parks Treasurer, Pinellas Bryan w Keswick Thursday, July 02, 2009 DeSoto Jemdfer E. Cloashey Dear MICHAEL D. JOHNSON, Hillsborough "II Comb°' The Southwest Florida Water Management District is pleased to send your State of Florida Water Polk Well Contractor's License. Below you will find your wallet -sized card. Patricia M. Glass Manatee Albert O. Io rger If you have any questions, please contact Well Construction at Sarasota (352) 796 -7211, extension 4495. Maritra Rovim-Forino Hillsborough H. Paul Senft, Jr. Polk Sincerely, Douglas B. Tharp Sumter Judith C. Whitehead Hernando Well Construction Regulation David L Moore Regulation Performance Management Department Executive Director William S. Sneaky Cc: Contractor file General Counsel STATE OF FLORIDA SO J S�' FLoirp;k TER t CEMENT D1S r %�DERT THAT a - WVIICHAEL D. iO SON .: HAS BEA, N.CENSED AS A yA g yi/ L CONTRAbif:,) I_N THE STATE F LICENSE NUi1§Bl?,,1i5 <• 7 :9Z7 EXPIRATION DATE: 07/31/2011 �� g , 1 FF r 1. t nt �}��S f' A � Y S .c .y. ti r ttf '"� '� n4 y r 4 Gdk 1 - t "� j' f " s '0 PO COUNTY LOCAL BUSfN TAX R E C E IPT ° ' * 1CCdUNT Nb 82 >, x 4 CLA A { EXPIRES,. 9/30/2 ( gi n DO NAME rz `1 ' "` �` a ` ' LO C ATION - t S M�IThf,(WAYN E D �,� -. � A n o Y 10U KID ELLIS R ' : F > r �;v M 1 , BUSINESS NAME AND MAILING # ADD R ESS , COD ACT T YPE a i 4 x ,4 230000 i LTDEN LICE CONSTRUG77 4 - r � {^ y '' » 1 js '�- `'CUSTO D�iILLING SERVICES IN "`" � ~ � S c i 5= j 77z a �r 'r s i " e a'- N r , r .t;, z X '� '�`Yy00 . = y � r ` � � °� � '�� t3' ��- � Y�� r � ---:,-::':_ii'., : MULBER FL 33860 £ t ' ,f k is a I+ - A 4� °i i * * 4 y s7^'. 'n ' o # t s.P . ,,+. 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PROFESSION, OR OCCIIi+ATIQ'N;BPECFIEDREREON. . <. „ %.1 2009-2010 HILL SS TAX RECEIPT EXPIRES 9 , s S • ' bb'' C OUN TY B USIN . , AC i. 3 �'. •" a .. S EMPLOYE 0.. 0, Q E 6 RENL ,i 0"Yi,t, CC. C O S TYPE t t 090.000 POLL c t la ' G YID 0C N X1 ,, 4:: .00° ry STAINES'S T k 1' 1 +.5 LOCATION TA • 9 ; . E N�zl‘xYNS G HAN e o f . ji c & R ENIEDIATION SE LLC . E u BUS INESS , ■ C I T DO BEIDEN, T Ax COLLECTOR > ID 7 6 '$ HEREBY PAID A PRIVILEGE TAX TO ENGAGE 813- 535.5200 �7/1 V`7 *' 58.00 K C • BUSINESS, PROFESSION, OR OCCUPATION SPECIFIED HEREON THIS BECOMES A TAX RECEIPT WHEN VALIDATED. 'ir 2009 - 2010 HILLSBOROUGH COUNTY B USINESS TAX RECEIPT EXPIRES 9 - 2010 Foy° , I FACILITIES OR MACHINES 0 I ROOMS 0 I SEATS 0 I EMPLOYEES RENEWAL �„ 1 169399. . OCC. CODE BUSINESS TYPE ` " WASTE TAX SURCHARGE 280.052 PUBLIC - VI - E ON TAL CO ULT T 22.00 M 1 0 BUSINESS 111 KELSEY LN E LOCATION TAMPA 33619 NAME HANDEX CONSULTING AND REMEDIATION MAILING SOUTHEAST LLC ADDRESS 111 KELSEY LN SUITE E TAMPA FL- 33619 -0009 B USINESS TAX RECEIPT DOUG LDEN, OLL Ofi PA - 27094 6 ' •HASHEREBY PAID A PRMLEGE TAX TO ENGAGE 813435 -5280 07/17/2009 *** 22.00 .- , . IN BUSINESS. PROFESSION, OR OCCUPATION SPECIFIED HEREON THIS BECOMES A TAX RECEIPT WHEN VALIDATED. Pasco County Property Appraiser - Legal Description for: 10- 26 -21- 0010 - 12800 -0090 Page 1 of 1 • • Welcome : Records Search : Parcel Details : Legal Description Legal Description 10- 26 -21- 0010 - 12800 -0090 Assessed in Section 10 , Township 26 South, Range 21 East of Pasco County, Florida ZEPHYRHILLS COLONY COMPANY LANDS PB 1 PG 55 A PART OF NORTH 1/2 OF TRACTS 127 & 128 LYING WEST & NORTH OF HARD SURFACED RD AS NOW ESTABLISHED & DESC AS COM AT SE COR SEC 10 TH NOODEG 04'25 "W 330.11 FT TH S89DEG 59'35 "W 191.50 FT FOR POB TH S89DEG 59'35 "W 487.32 FT TH N74DEG 28'35 "E 400.30 FT TH N80DEG 09'35 "E 90.83 FT TH S59DEG 36'25 "E 92.74 FT TH S41 DEG 59'35 "W 102.05 FT TO POB LESS THAT PART OF ABOVE DESCRIBED LAND WHICH LIES WEST OF NELY LINE OF LOT 2 BLOCK B EXTENDED OF ZEPHYR OASIS PB 3 PG 71 OR 5288 PG 1751 & OR 5288 PG 1754 Please be advised that our legal descriptions are for assessment purposes only, and are not intended for use in legal conveyances. Pasco County Property Appraiser Page Layout Modified: 2/17/2009 11:49:04 AM The Local Time Is: 5/5/2010 10:59:50 AM http : / /appraiser.pascogov. com/search/legal. aspx ?parcel= 2126100010128000090 &cache =... 05/05/2010 ATTACHMENT B FIGURES ATTACHMENT C UTILITY NOTIFICATION DOCUMENTATION Hess, Jeremy From: irth_host @callsunshine.com Sent: Friday, May 07, 2010 4:07 PM To: Hess, Jeremy Subject: Response to Sunshine State One Call ticket 125001859 The following facility operators have responded for this locate request: Ticket 125001859 FL : PASCO County, ZEPHYRHILLS City 5039 1ST ST BRIGHT HOUSE NETWORKS- EAST PASCO - No Conflict - utility is outside of the requested work site CITY OF ZEPHYRHILLS - Marked PROGRESS ENERGY - ST PETERSBURG - Clear No Facilities VERIZON FLORIDA INC - Marked WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE - Clear No Facilities The most up -to -date response status can always be gathered at http: / /www2 .callsunshine.com /irthinternet/ , or by calling 1- 800 - 852 -8057. 1 Response Status Page 1 of 1 irth nternet U S Copyright 2005 AGT International, Inc. All rights reserved. 711; caaC HomeOwner View Response Ticket ID: 1125001859 Phone Number: 181362646461129 Search 1 Ticket Information Did Site Data Excavator Data Company Name: HANDEX Ticket ID: 125001859 CONSULTING & REMEDIATION SE LLC Street Name: 1ST ST Contact: JEREMY HESS Place: ZEPHYRHILLS Phone Number: (813) 626 -4646 x1129 County: PASCO Street: 111 KELSEY LN State: FL City, State: Zip: 33619 View Ticket Text 1 Ticket Status: OPEN Service Area Name Response BRIGHT HOUSE NETWORKS- EAST PASCO (5) - No Conflict - utility is outside of the requested work site CITY OF ZEPHYRHILLS (1) - Marked PROGRESS ENERGY - ST PETERSBURG (4) - Clear No Facilities VERIZON FLORIDA INC (1) - Marked WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE (4) - Clear No Facilities http : / /www2. c allsunshine. com/irthintemet/ PositiveResponse /HomeOwner/HomeOwnerV ... 05/10/2010 • Hess, Jeremy From: firth host @callsunshine.com Sent: Wednesday, May 05, 2010 9:51 AM To: Hess, Jeremy Subject: SSOCOF CONFRM 2010/05/05 #00001 125001859 -000 NORM NEW CONFRM 00001 CALL SUNSHINE 05/05/10 09:50:49ET 125001859 -000 STREET Ticket : 125001859 Rev:000 Taken: 05/05/10 09:46ET State: FL Cnty: PASCO GeoPlace: ZEPHYRHILLS CallerPlace: ZEPHYRHILLS Subdivision: Address : 5039 Street : 1ST ST Cross 1 : SR 54 Within 1/4 mile: Y Locat: LOCATE FRONT R /O /W ALONG 1ST ST AT 5039 1ST ST Remarks : * ** LOOKUP BY ADDRESS * ** Grids : 2813A8211C 2813A8211D Work date: 05/10/10 Time: 08:00ET Hrs notc: 070 Category: 3 Duration: 01 DAY Due Date : 05/07/10 Time: 23:59ET Exp Date : 06/04/10 Time: 23:59ET Work type: WELL INSTALLATION Boring: N White - lined: N Ug /Oh /Both: U Machinery: Y Depth: 35FT Permits: Y PENDING Done for : FDEP Company : HANDEX CONSULTING & REMEDIATION SE LLC Type: CONT Co addr : 111 KELSEY LN Co addr2: SUITE E City : TAMPA State: FL Zip: 33619 Caller : JEREMY HESS Phone: 813- 626 -4646 Ext: 1129 Contact : JEREMY HESS Phone: 813 - 626 -4646 Ext: 1129 BestTime: 8 -5 Mobile : 727 - 254 -3063 Fax : 813- 626 -1898 Email : JHESS @HANDEXMAIL.COM Submitted: 05/05/10 09:46ET Oper: PAT Chan: 20 Mbrs : BE1783 CZ1084 FPC314 GT1722 CU1714 1 Hess, Jeremy From: irth_host @callsunshine.com Sent: Wednesday, May 05, 2010 9:52 AM To: Hess, Jeremy Subject: SSOCOF CONFRM 2010/05/05 #00001 125001859 -001 NORM 2NDR CONFRM 00001 CALL SUNSHINE 05/05/10 09:52:25ET 125001859 -001 REXMIT NOSHOW STREET Ticket : 125001859 Rev:001 Taken: 05/05/10 09:50ET Old Tkt: 125001859 Taken: 05/05/10 09:46ET Oper: PAT State: FL Cnty: PASCO GeoPlace: ZEPHYRHILLS CallerPlace: ZEPHYRHILLS Subdivision: Address : 5039 Street : 1ST ST Cross 1 : SR 54 Within 1/4 mile: Y Locat: LOCATE FRONT R /O /W ALONG 1ST ST AT 5039 1ST ST Remarks : 2ND NOTICE REQUESTED BY JERMEY HESS TO ADD WITHLACOOCHEE RIVER ELECTRIC * WRE845 WAS MANUALLY ADDED TO THIS TICKET, PLEASE CHECK YOUR DATABASE * WRE845 WAS NOT ON THE ORIGINAL VERSION OF THIS TICKET * ** LOOKUP BY ADDRESS * ** Grids : 2813A8211C 2813A8211D Work date: 05/10/10 Time: 08:00ET Hrs notc: 070 Category: 3 Duration: 01 DAY Due Date : 05/07/10 Time: 23:59ET Exp Date : 06/04/10 Time: 23:59ET Work type: WELL INSTALLATION Boring: N White - lined: N Ug /Oh /Both: U Machinery: Y Depth: 35FT Permits: Y PENDING Done for : FDEP Company : HANDEX CONSULTING & REMEDIATION SE LLC Type: CONT Co addr : 111 KELSEY LN Co addr2: SUITE E City : TAMPA State: FL Zip: 33619 Caller : JEREMY HESS Phone: 813 - 626 -4646 Ext: 1129 Contact : JEREMY HESS Phone: 813- 626 -4646 Ext: 1129 BestTime: 8 -5 Mobile : 727 - 254 -3063 Fax : 813- 626 -1898 Email : JHESS @HANDEXMAIL.COM Submitted: 05/05/10 09:50ET Oper: PAT Chan: 20 Mbrs : BE1783 CZ1084 FPC314 GT1722 WRE845 CU1714 LS1104 1 Page 1 of 2 Ticket : 125001859 Rev:001 Taken: 05/05/10 09:50ET Old Tkt: 125001859 Taken: 05/05/10 09:46ET Oper: PAT State: FL Cnty: PASCO GeoPlace: ZEPHYRHILLS CallerPlace: ZEPHYRHILLS Subdivision: Address : 5039 Street : 1ST ST Cross 1 : SR 54 Within 1/4 mile: Y Locat: LOCATE FRONT R /O /W ALONG 1ST ST AT 5039 1ST ST Remarks : 2ND NOTICE REQUESTED BY JERMEY HESS TO ADD WITHLACOOCHEE RIVER ELECTRIC * WRE845 WAS MANUALLY ADDED TO THIS TICKET, PLEASE CHECK YOUR DATABASE * WRE845 WAS NOT ON THE ORIGINAL VERSION OF THIS TICKET * ** LOOKUP BY ADDRESS * ** Grids : 2813A8211C 2813A8211D Work date: 05/10/10 Time: 08:00ET Hrs notc: 070 Category: 3 Duration: 01 DAY Due Date : 05/07/10 Time: 23:59ET Exp Date : 06/04/10 Time: 23:59ET Work type: WELL INSTALLATION Boring: N White - lined: N Ug /Oh /Both: U Machinery: Y Depth: 35FT Permits: Y PENDING Done for : FDEP Company : HANDEX CONSULTING & REMEDIATION SE LLC Type: CONT Co addr : 111 KELSEY LN Co addr2: SUITE E City : TAMPA State: FL Zip: 33619 Caller : JEREMY HESS Phone: 813 - 626 -4646 Ext: 1129 Contact : JEREMY HESS Phone: 813 - 626 -4646 Ext: 1129 BestTime: 8 -5 Mobile : 727 - 254 -3063 Fax : 813 - 626 -1898 Email : JHESS @HANDEXMAIL.COM Submitted: 05/05/10 09:50ET Oper: PAT Chan: 20 Mbrs : BE1783 CZ1084 FPC314 GT1722 WRE845 CU1714 LS1104 Service Area Contact Phone Number Utility Type Day: 7275317656 BE1783 BRIGHT HOUSE NETWORKS- MATT MASI - ELM Alt: CABLE,FIBER EAST PASCO LOCATING Emerg: Day: 8137146311 CZ1084 CITY OF ZEPHYRHILLS CITY OF Alt: WATER AND ZEPHYRHILLS SEWER Emerg: PROGRESS ENERGY - ST CENTRAL LOCATING Day: 8007789140 FPC314 PETERSBURG SERVICE ** Alt: ELECTRIC http : / /www2. c al lsunshine. com /irthinternet /Me s sageText /MessageText. asp ?NoticelD =SU... 05/05/2010 Page 2 of 2 Emerg: Day: 3369926100 GT1722 VERIZON FLORIDA INC Dispatch Office Alt: Emerg: Day: 8007789140 WRE845 WITHLACOOCHEE RIVER CENTRAL LOCATING Alt: ELECTRIC ELECTRIC COOPERATIVE SERVICE ** Emerg: http: / /www2.callsunshine. com /irthinternet/ MessageText /MessageText.asp ?NoticelD =SU... 05/05/2010 a z N � N O_ C, o b y C" o • rri d o c-) a O O � y n A a a d y r� y 1 to tTl NOV -12 -2010 11:58 From: 8634259620 Pa9e:2 /2 w ere o$ — y N g d m so z C] � Y L / v1 m m d CC a W .. V O EO E 4' > � E � .. • O Z ta . -- v m g ca 3 O � ` C - " - ' d C 0,8.9. J E a� � O c am' g �€ OWa c � if 1 D a $ w ~ v [ a 00 cri .0 D O g o 34 t N ~ 1 i v. P O `� g 2 O,- O Z A a d c d et d c� e. J m ° ° ° $ a t tlJ N G m 8 i, . Y z. N O n • C a' v _ L U la d�J J ` 7f _ t t W E m E a, Z Z R 0 p C J J d 45 j } . • C.3 —8 U .0 0 u- F• O LL it? J G7 6 IA. 0 d 0 Q a. d - . o d V C to o �- P y y W C � P3 'v a x g . 12 St a�i N f CO 4.) ,A cv W N A S V C Si m E ID RI C • 2 J y 0. $i 11) K — CD v p 0. m 55 • b C) i d V 11 — m y F� • a$ @ • • m a m t Ex e'n * c O == UN o , z ,cam ,e F _ x B = v a �• W iii §S US N w r.: o o � o .e 0 x c, J Z U Q i 02 F o Q w c a °° a N IE ; ll u l I i ; ae 2 a t' c 8 0 CD o M' m H d .,- JJ Q N /O 3 m y J -0 c wvlo C7 O 7 0.5 c lq � NOV-12-2010 11:58 From:8634259620 Pa9e:1'2 p . t ( 0 cr5-S CUSTOM DRILLING SERVICES, INC. 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