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1231-Commun Ctr/SJRWMD4049 Reid Street • P.O. Box 1429 • Palatka, FL 32178 -1429 • (386) 329 -4500 On the Internet at wKwww.sjrwmd.com. July 7, 2008 City of Sanford PO Box 1778 Sanford, FL 32772 f SUBJECT: Permit Number 40- 117 - 22397 -13 Sanford Community Center Dear Sir /Madam: Enclosed is your general permit as authorized by the staff of the St. Johns River Water Management District on July 7, 2008. This permit is a legal document and should be kept with your other important documents. The attached MSSW /Stormwater As -Built Certification Form should be filled in and returned to the Palatka office within thirty days after the work is completed. By so doing, you will enable us to schedule a prompt inspection of the permitted activity. In addition to the MSSW /Stormwater As -Built Certification Form, your permit also contains conditions which require submittal of additional information. All information submitted as compliance to permit conditions must be submitted to the Palatka office address. Permit issuance does not relieve you from the responsibility of obtaining permits from any federal, state and /or local agencies asserting concurrent jurisdiction for this work. Please be advised that the District has not published a notice in the newspaper advising the public that it is issuing a permit for this proposed project. Publication, using the District form, notifies members of the public (third parties) of their rights to challenge the issuance of the general permit. If proper notice is given by publication, third parties have a 21 -day time limit on . the time they have to file a petition opposing the issuance of the permit. If you do not publish, a party's right to challenge the issuance of the general permit extends for an indefinite period of time. If you wish to have certainty that the period for filing such a challenge is closed, then you may publish, at your own expense, such a notice in a newspaper of general circulation. A copy of the form of the notice and a list of newspapers of general circulation is attached for your use. In the event you sell your property, the permit will be transferred to the new owner, if we are notified by you within thirty days of the sale and if you provide the information required by 40C- 1.612, F.A.C. Please assist us in this matter so as to maintain a valid permit for the new property owner. GOVERNING BOARD David G. Graham, CHAIRMAN Susan N. Hughes, VICE CHAIRMAN Anil T. Moore, SECRETARY W. Leonard Wood, TREASURER JACKSONVILLE PONTE VEDRA BUNNELL FERNANDINA BEACH Douglas C. Bournique Michael Ertel Hersey "Herky" Huffman Arlen N. Jumper Hans G. Tanzler If VERO BEACH OVIEDO ENTERPRISE FORT McCOY JACKSONVILLE Thank you for your cooperation, and if this office can be of any further assistance to you, please do not hesitate to contact us. Sincerely, Marianella Pacheco Regulatory Info Mgmt Spec II Division of Regulatory Information Management Enclosures: Permit with As -built Certification Form Notice of Rights List of Newspapers for Publication cc: District Permit File Consultant: CPH Engineers, Inc. PO Box 2808 Sanford, FL 32772 ST. JOHNS RIVER WATER MANAGEMENT DISTRICT Post Office Box 1429 Palatka, Florida 32178 -1429 PERMIT NO. 40- 117 - 22397 -13 DATE ISSUED: July 7, 2008 PROJECT NAME: Sanford Community Center A PERMIT AUTHORIZING: Construction and operation of a Surface Water Management System for a city community center known as the Sanford Community Center, a 3.03 -acre project. This permit authorizes 0.19 -acres of work within upland cut ditches and other surface waters. LOCATION: Section(s): 34,39 Township(s): 19S Range(s): 30E Seminole County City of Sanford PO Box 1778 Sanford, FL 32772 Permittee agrees to hold and save the St. Johns River Water Management District and its successors harmless from any and all damages, claims, or liabilities which may arise from permit issuance. Said application, including all plans and specifications attached thereto, is by reference made a part hereof. This permit does not convey to permittee any property rights nor any rights of privileges other than those specified herein, nor relieve the permittee from complying with any law, regulation or requirement affecting the rights of other bodies or agencies. All structures and works installed by permittee hereunder shall remain the property of the permittee. This permit may be revoked, modified or transferred at any time pursuant to the appropriate provisions of Chapter 373, Florida Statutes: PERMIT IS CONDITIONED UPON: See conditions on attached "Exhibit A ", dated July 7, 2008 AUTHORIZED BY: St. Johns River Water Management District n DepartmMt of Resource Management rings) David Dewey "EXHIBIT A" CONDITIONS FOR ISSUANCE OF PERMIT NUMBER 40- 117 - 22397 -13 CITY OF SANFORD DATED JULY 7, 2008 1. All activities shall be implemented as set forth in the plans, specifications and performance criteria as approved by this permit. Any deviation from the permitted activity and the conditions for undertaking that activity shall constitute a violation of this permit. 2. This permit or a copy thereof, complete with all conditions, attachments, exhibits, and modifications, shall be kept at the work site of the permitted activity. The complete permit shall be available for review at the work site upon request by District staff. The permittee shall require the contractor to review the complete permit prior to commencement of the activity authorized by this permit. 3. Activities approved by this permit shall be conducted in a manner which do not cause violations of state water quality standards. 4. Prior to and during construction, the permittee shall implement and maintain all erosion and sediment control measures (best management practices) required to retain sediment on -site and to prevent violations of state water quality standards. All practices must be in accordance with the guidelines and specifications in chapter 6 of the Florida Land Development Manual: A Guide to Sound Land and Water Management (Florida Department of Environmental Regulation 1988), which are incorporated by reference, unless a project specific erosion and sediment control plan is approved as part of the permit, in which case the practices must be in accordance with the plan. If site specific conditions require additional measures during any phase of construction or operation to prevent erosion or control sediment, beyond those specified in the erosion and sediment control plan, the permittee shall implement additional best management practices as necessary, in accordance with the specifications in chapter 6 of the Florida Land Development Manual: A Guide to Sound Land and Water Management (Florida Department of Environmental Regulation 1988). The permittee shall correct any erosion or shoaling that causes adverse impacts to the water resources. 5. Stabilization measures shall be initiated for erosion and sediment control on disturbed areas as soon as practicable in portions of the site where construction activities have temporarily or permanently ceased, but in no case more than 7 days after the construction activity in that portion of the site has temporarily or permanently ceased. 6. At least 48 hours prior to commencement of activity authorized by this permit, the permittee shall submit to the District a Construction Commencement Notice Form No. 40C- 4.900(3) indicating the actual start date and the expected completion date. 7. When the duration of construction will exceed one year, the permittee shall submit construction status reports to the District on an annual basis utilizing an Annual Status Report Form No. 40C- 4.900(4). These forms shall be submitted during June of each year. 8. For those systems which will be operated or maintained by an entity which will require an easement or deed restriction in order to provide that entity with the authority necessary to operate or maintain the system, such easement or deed restriction, together with any other final operation or maintenance documents as are required by subsections 7.1.1 through 7.1.4 of the Applicant's Handbook: Management and Storage of Surface Waters, must be submitted to the District for approval. Documents meeting the requirements set forth in these subsections of the Applicant's Handbook will be approved. Deed restrictions, easements and other operation and maintenance documents which require recordation either with the Secretary of State or the Clerk of the Circuit Court must be so recorded prior to lot or unit sales within the project served by the system, or upon completion of construction of the system, whichever occurs first. For those systems which are proposed to be maintained by county or municipal entities, final operation and maintenance documents must be received by the District when maintenance and operation of the system is accepted by the local governmental entity. Failure to submit the appropriate final documents referenced in this paragraph will result in the permittee remaining liable for carrying out maintenance and operation of the permitted system. 9. Each phase or independent portion of the permitted system must be completed in accordance with the permitted plans and permit conditions prior to the initiation of the permitted use of site infrastructure located within the area served by the portion or phase of the system. Each phase or independent portion of the system must be completed in accordance with the permitted plans and permit conditions prior to transfer of responsibility for operation and maintenance of that phase or portion of the system to local government or other responsible entity. 10. Within 30 days after completion of construction of the permitted system, or independent portion of the system, the permittee shall submit a written statement of completion and certification by a registered professional engineer or other appropriate individual as authorized by law, utilizing As Built Certification Form 40C- 1.181(13) or 40C- 1.181(14) supplied with this permit. When the completed system differs substantially from the permitted plans, any substantial deviations shall be noted and explained and two copies of as -built drawings submitted to the District. Submittal of the completed from shall serve to notify the District that the system is ready for inspection. The statement of completion and certification shall be based on on -site observation of construction (conducted by the registered professional engineer, or other appropriate individual as authorized by law, or under his or her direct supervision) or review of as -built drawings for the purpose of determining if the work was completed in compliance with approved plans and specifications. As -built drawings shall be the permitted drawings revised to reflect any changes made during construction. Both the original and any revised specifications must be clearly shown. The plans must be clearly labeled as "as- built" or "record" drawing. All surveyed dimensions and elevations shall be certified by a registered surveyor. The following information, at a minimum, shall be verified on the as -built drawings: 1. Dimensions and elevations of all discharge structures including all weirs, slots, gates, pumps, pipes, and oil and grease skimmers; 2. Locations, dimensions, and elevations of all filter, exfiltration, or underdrain systems including cleanouts, pipes, connections to control structures, and points of discharge to the receiving waters; 3. Dimensions, elevations, contours, or cross - sections of all treatment storage areas sufficient to determine state - storage relationships of the storage area and the permanent pool depth and volume below the control elevation for normally wet systems, when appropriate; 4. Dimensions, elevations, contours, final grades, or cross - sections of the system to determine flow directions and conveyance of runoff to the treatment system; 5. Dimensions, elevations, contours, final grades, or cross - sections of all conveyance systems utilized to convey off -site runoff around the system; 6. Existing water elevation(s) and the date determined; and Elevation and location of benchmark(s) for the survey. 11. The operation phase of this permit shall not become effective until the permittee has complied with the requirements of general condition 9 above, the District determines the system to be in compliance with the permitted plans, and the entity approved by the District in accordance with subsections 7.1.1 through 7.1.4 of the Applicant's Handbook: Management and Storage of Surface Waters, accepts responsibility for operation and maintenance of the system. The permit may not be transferred to such an approved operation and maintenance entity until the operation phase of the permit becomes effective. Following inspection and approval of the permitted system by the District, the permittee shall request transfer of the permit to the responsible approved operation and maintenance entity, if different from the permittee. Until the permit is transferred pursuant to section 7.1 of the Applicant's Handbook: Management and Storage of Surface Waters, the permittee shall be liable for compliance with the terms of the permit. 12. Should any other regulatory agency require changes to the permitted system, the permittee shall provide written notification to the District of the changes prior implementation so that a determination can be made whether a permit modification is required. 13. This permit does not eliminate the necessity to obtain any required federal, state, local and special district authorizations prior to the start of any activity approved by this permit. This permit does not convey to the permittee or create in the permittee any property right, or any interest in real property, nor does it authorize any entrance upon or activities on property which is not owned or controlled by the permittee, or convey any rights or privileges other than those specified in the permit and chapter 40C -4 or chapter 40C -40, F.A.C. 14. The permittee shall hold and save the District harmless from any and all damages, claims, or liabilities which may arise by reason of the activities authorized by the permit or any use of the permitted system. 15. Any delineation of the extent of a wetland or other surface water submitted as part of the permit application, including plans or other supporting documentation, shall not be considered specifically approved unless a specific condition of this permit or a formal determination under rule 40C- 1.1006, F.A.C., provides otherwise. 16. The permittee shall notify the District in writing within 30 days of any sale, conveyance, or other transfer of ownership or control of the permitted system or the real property at which the permitted system is located. All transfers of ownership or transfers of a permit are subject to the requirements of rule 40C- 1.612, F.A.C. The permittee transferring the permit shall remain liable for any corrective actions that may be required as a result of any permit violations prior to such sale, conveyance or other transfer. 17. Upon reasonable notice to the permittee, District authorized staff with proper identification shall have permission to enter, inspect, sample and test the system to insure conformity with the plans and specifications approved by the permit. 18. If historical or archaeological artifacts are discovered at any time on the project site, the permittee shall immediately notify the District. 19. The permittee shall immediately notify the District in writing of any previously submitted information that is later discovered to be inaccurate. 20. This permit for construction will expire five years from the date of issuance. 21. All wetland areas or water bodies that are outside the specific limits of construction authorized by this permit must be protected from erosion, siltation, scouring or excess turbidity, and dewatering. 22. Prior to construction, the permittee must clearly designate the limits of construction on -site. The permittee must advise the contractor that any work outside the limits of construction, including clearing, may be a violation of this permit. 23. The operation and maintenance entity shall submit inspection reports to the District one year after the operation phase permit becomes effective and every two years thereafter on District for EN -46. The inspection form must be signed and sealed by an appropriate registered professional. 24. The proposed surface water management system must be constructed as per plans received by the District on July 2, 2008, and as amended by Plan Sheets C -5, C -10, IR -1 and IR -2 received by the District on July 7, 2008. 25. This permit authorizes 0.19 -acres of work in surface waters. Notice Of Rights A person whose substantial interests are or may be affected has the right to request an administrative hearing by filing a written petition with the St. Johns River Water Management District (District). Pursuant to Chapter 28 -106 and Rule 40C- 1.1007, Florida Administrative Code, the petition must be filed (received) either by delivery at the office of the District Clerk at District Headquarters, P. O. Box 1429, Palatka Florida 32178 -1429 (4049 Reid St., Palatka, FL 32177) or by e-mail with the District Clerk at Clerk(a)sirwmd.com, within twenty -six (26) days of the District depositing notice of District decision in the mail (for those persons to whom the District mails actual notice), within twenty -one (21) days of the District emailing notice of District decision (for those persons to whom the District emails actual notice), or within twenty -one (21) days of newspaper publication of the notice of District decision (for those persons to whom the District does not mail or email actual notice). A petition must comply with Sections 120.54(5)(b)4. and 120.569(2)(c), Florida Statutes, and Chapter 28 -106, Florida Administrative Code. The District will not accept a petition sent by facsimile (fax), as explained in paragraph no. 5 below. Mediation pursuant to Section 120.573, Florida Statutes, is not available. 2. If the Governing Board takes action that substantially differs from the notice of District decision, a person whose substantial interests are or may be affected has the right to request an administrative hearing by filing a written petition with the District, but this request for administrative hearing shall only address the substantial deviation. Pursuant to Chapter 28 -106 and Rule 40C- 1.1007, Florida Administrative Code, the petition must be filed (received) at the office of the District Clerk at the mail /street address or email address described in paragraph no. 1 above, within twenty -six (26) days of the District depositing notice of final District decision in the mail (for those persons to whom the District mails actual notice), within twenty -one (21) days of the District emailing the notice of final District decision (for those persons to whom the District emails actual notice), or within twenty -one (21) days of newspaper publication of the notice of final District decision (for those persons to whom the District does not mail or email actual notice). A petition must comply with Sections 120.54(5)(b)4. and 120.569(2)(c), Florida Statutes, and Chapter 28 -106, Florida Administrative Code. Mediation pursuant to Section 120.573, Florida Statutes, is not available. 3. A person whose substantial interests are or may be affected has the right to a formal administrative hearing pursuant to Sections 120.569 and 120.57(1), Florida Statutes, where there is a dispute between the District and the party regarding an issue of material fact. A petition for formal hearing must also comply with the requirements set forth in Rule 28- 106.201, Florida Administrative Code. 4. A person whose substantial interests are or may be affected has the right to an informal administrative hearing pursuant to Sections 120.569 and 120.57(2), Florida Statutes, where no material facts are in dispute. A petition for an informal hearing must also comply with the requirements set forth in Rule 28- 106.301, Florida Administrative Code. Notice Of Rights 5. A petition for an administrative hearing is deemed filed upon receipt of the complete petition by the District Clerk at the District Headquarters in Palatka, Florida. Petitions received by the District Clerk after 5:00 p.m., or on a Saturday, Sunday, or legal holiday, shall be deemed filed as of 8:00 a.m. on the next regular District business day. The District's acceptance of petitions filed by e-mail is subject to certain conditions set forth in the District's Statement of Agency Organization and Operation (issued pursuant to Rule 28- 101.001, Florida Administrative Code), which is available for viewing at www.smrwmd.com These conditions include, but are not limited to, the petition being in the form of a PDF file and being capable of being stored and printed by the District. Further, pursuant to the District's Statement of Agency Organization and Operation, attempting to file a petition by facsimile is prohibited and shall not constitute filing. 6. Failure to file a petition for an administrative hearing within the requisite time frame shall constitute a waiver of the right to an administrative hearing. (Rule 28- 106.111, Florida Administrative Code). 7. The right to an administrative hearing and the relevant procedures to be followed are governed by Chapter 120, Florida Statutes, Chapter 28 -106, Florida Administrative Code, and Rule 40C- 1.1007, Florida Administrative Code. Because the administrative hearing process is designed to formulate final agency action, the filing of a petition means the District's final action may be different from the position taken by it in this notice. A person whose substantial interests are or may be affected by the District's final action has the right to become a party to the proceeding, in accordance with the requirements set forth above. 8. A person with a legal or equitable interest in real property who believes that a District permitting action is unreasonable or will unfairly burden the use of their property, has the right to, within 30 days of receipt of the notice of District decision regarding a permit application, apply for a special magistrate proceeding under Section 70.51, Florida Statutes, by filing a written request for relief at the Office of the District Clerk located at District Headquarters, P. O. Box 1429, Palatka, FL 32178 -1429 (4049 Reid St., Palatka, FL 32177). A request for relief must contain the information listed in Subsection 70.51(6), Florida Statutes. Requests for relief received by the District Clerk after 5:00 p.m., or on a Saturday, Sunday, or legal holiday, shall be deemed filed as of 8:00 a.m. on the next regular District business day. 9. A timely filed request for relief under Section 70.51, Florida Statutes, tolls the time to request an administrative hearing under paragraph nos. 1 or 2 above. (Paragraph 70.51(10)(b), Florida Statutes). However, the filing of a request for an administrative hearing under paragraph nos. 1 or 2 above waives the right to a special magistrate proceeding. (Subsection 70.51(10)(b), Florida Statutes). 10. Failure to file a request for relief within the requisite time frame shall constitute a waiver of the right to a special magistrate proceeding. (Subsection 70.51(3), Florida Statutes). Notice Of Rights 11. Any person whose substantial interests are or may be affected who claims that final action of the District constitutes an unconstitutional taking of property without just compensation may seek review of the action in circuit court pursuant to Section 373.617, Florida Statutes, and the Florida Rules of Civil Procedures, by filing an action in circuit court within 90 days of rendering of the final District action, (Section 373.617, Florida Statutes). 12. Pursuant to Section 120.68, Florida Statutes, a party to the proceeding before the District who is adversely affected by final District action may seek review of the action in the District Court of Appeal by filing a notice of appeal pursuant to Rules 9.110 and 9.190, Florida Rules of Appellate Procedure, within 30 days of the rendering of the final District action. 13. A party to the proceeding before the District who claims that a District order is inconsistent with the provisions and purposes of Chapter 373, Florida Statutes, may seek review of the order pursuant to Section 373.114, Florida Statutes, by the Florida Land and Water Adjudicatory Commission, by filing a request for review with the Commission and serving a copy on the Florida Department of Environmental Protection and any person named in the order within 20 days of the rendering of the District order. 14. A District action is considered rendered, as referred to in paragraph nos. 11, 12, and 13 above, after it is signed on behalf of the District, and is filed by the District Clerk. 15. Failure to observe the relevant time frames for filing a petition for judicial review as described in paragraph nos. 11 and 12 above, or for Commission review as described in paragraph no. 13 above, will result in waiver of that right to review. Notice Of Rights Certificate of Service I HEREBY CERTIFY that a copy of the foregoing Notice of Rights has been sent by U.S. Mail to: City of Sanford PO Box 1778 Sanford, FL 32772 At 4:00 p.m. this 7th day of July, 2008. rmom�1160 Division of Regulatory Information Management Gloria Lewis, Director St. Johns River Water Management District Post Office Box 1429 Palatka, FL 32178 -1429 (386) 329 -4152 Permit Number: 40-117-22397-13 . John r. .ter Management District Kirby B. Green III, Executive Director - David W, Fisk, Assistant Executive Director 4049 Reid Street • P.O. Box 1429 * Palatka, FL 32178 -1429 • (386) 329 -4500 On the Internet at www.sjrwmd.com. Holders of General Permits Dear Permittee: Please be advised that the District has not published a notice in the newspaper advising the public that it is issuing a permit for this proposed project. Publication, using the District form, notifies members of the public (third parties) of their rights to challenge the issuance of the permit. If proper notice is given by publication, third parties have a 21 -day time limit on the time they have to file a petition opposing the issuance of the permit. To confirm the period for filing such a challenge is closed, you may publish (at your own expense) a notice in a newspaper of general circulation within the affected area. If you do not publish, a person's right to challenge the issuance of the general permit extends for an indefinite period of time. A copy of the form of the notice and a list of newspapers of general circulation commonly used by the District is attached for your use. However, you do not have to use only those newspapers listed and this publication need only appear once When the notice is published, the newspaper will return to you an affidavit as proof of publication. To complete your file with the District, submit.this original affidavit of publication to: Gloria Lewis, Director Division of Regulatory Information Management P. 0. Box 1429 Palatka, FL 32178 -1429 (386) 329 -4235 Enclosed is a sample package used for newspaper noticing by the District. Particular attention should be given to Pages 2 and 3 for successful completion of the newspaper noticing process. If we can be of further assistance, please contact Shannon Barican at (386) 329 -4266 or Quenteria Johnson at (386) 329 -4349. Sincerely, 2A-A— Gloria Lewis, Director Division of Regulatory Information Management GOVERNING BOARD David G. Graham, CHAIRMAN Susan N. Hughes, VICE CHAIRMAN Ann T. Moore, BECRETARY W, Leonard Wood, TREA.SuRER JACKSONVILLE PONTE VEDRA BUNNELL FERNANDINA BEACH Douglas C, Bournique Michael Ertel Hersey "Herky" Huffman Arlen N. Jumper Hans G. Tanzler III VERO BEACH OVIEDO ENTERPRISE FORT WCOY JACKSONVILLE NOTICE OF AGENCY ACTION TAKEN BY THE ST. JOHNS RIVER WATER MANAGEMENT DISTRICT Notice is given that the following permit was issued on (Name and address of applicant) permit # . The project is located in County, Section , Township South, Range East. The permit authorizes A SURFACE WATER MANAGEMENT SYSTEM ON ACRES TO SERVE known as The receiving water body is The file(s) containing the application for the above listed permit is available for inspection. Monday through Friday except for legal holidays, 8:00 a.m. to 5:00 p.m. at the St. Johns River Water Management District (District) Headquarters, 4049 Reid Street, Palatka, FL 32178 -1429. A person whose substantial interests are affected by the District permitting decision may petition for an administrative hearing in accordance with sections 120.569 and 120.57, Florida Statutes, or may choose to pursue mediation as an alternative remedy under section 120.573, Florida Statutes, before the deadline for filing a petition. Choosing mediation will not adversely affect the right to a hearing if mediation does not result in a settlement. The procedures for pursuing mediation are set forth in section 120.573, Florida Statutes, and rules 28- 106.111 and 28- 106.401 -.404 Florida Administrative Code. Petitions must comply with the requirements of Florida Administrative Code Chapter 28 -106 and be filed with (received by) the District Clerk located at District Headquarters, Highway 100 West, Palatka, FL 32177. Petitions for administrative hearing on the above application(s) must be filed within twenty -one (21) days of publication of this notice or within twenty - six (26) days of the District depositing notice of this intent in the mail for those persons to whom the District mails actual notice. Failure to file a petition within this time period shall constitute a waiver of any right(s) such person(s) may have to request an administrative determination (hearing) under sections 120.569 and 120.57, F.S., concerning the subject permit. Petitions that are not filed in accordance with the above provisions are subject to dismissal. Because the administrative hearing process is designed to formulate final agency action, the filing of a petition means that the District's final action may be different from the position taken by it in this notice of intent. Persons whose substantial interests will be affected by any such final decision of the District on the applicant have the right to petition to become a party to the proceeding, in accordance with the requirements set forth above. Revised August 27, 2007 H: /pds /data/Holders of General Permits ALA CHUA The Alachua County Record Legal Advertising P. 0. Box 806 Gainesville, FL 32602 352 - 377 -2444 /fax 352 - 338 -1986 BAKER Baker County Press Legal Advertising P. 0. Box 598 Maclenny, FL 32063 904 - 259- 2400/fax 904 - 259 -6502 BRADFORD Bradford County Telegraph Legal Advertising P. 0. Drawer A Starke, FL 32901 904 - 964- 630Stfax 904 - 964 -8628 BREVARD Florida Today, Legal Advertising P. 0. Box 419000 Melbourne, FL 32941 -9000 321- 242- 3500/fax 321 - 242 -6618 CLAY Clay Today, Legal Advertising 1560 Kinsiey Ave., Suite 1 Orange Park, FL 32073 904264 - 3200 /fax 904 -269 -6958 DUVAL Florida Times Union Legal Advertising 1 Riverside Avenue Jacksonville, FL 32202 904359- 4321/fax 904 - 359 -4180 FLAGLER Flagier Tribune, c/o News Journal P. 0. Box 2831 Daytona Beach, FL 32120 -2831 Revised August 27, 2007 H: /pds /data/Holders of General Permits (386) 740 -4503 /fax (386) 736 -8972 INDIAN RIVER Vero Beach Press Journal Legal Advertising P. 0. Box 1268 Vero Beach, FL 32961 -1268 772 - 978- 2214/fax 772- 978 -2340 LAKE Daily Commercial Legal Advertising P. 0. Drawer 490007 Leesburg, FL 34749 352 - 365 - 8230 /fax 352 - 365 -1951 I I Ocala Star Banner, Legal Advertising 2121 SW 19' Avenue Road Ocala, FL 34474 352 - 867 - 4010 /fax 352 - 867 -4126 NASSAU News- Leader, Legal Advertising P. 0. Box 766 Fernandina Beach, FL 32035 904 - 261- 3696/fax 904- 261 -3698 OKEECHOBEE Okeechobee News Legal Advertising P. 0. Box 639 Okeechobee, FL 34973 -0639 863 - 763- 31341fax 863 - 763 -5901 ORANGE Sentinel Communications Legal Advertising 633 N. Orange Avenue Orlando, FL 32801 407 -420- 5160 /fax 407 -420 -5011 OSCEOLA Little Sentinel Legal Advertising 633 N. Orange Avenue 3 Orlando, FL 32801 407 - 420 - 5160 /fax 407 - 420 -5011 I POLK Lakeland Ledger Publishing Co. Legal Advertising R 0. Box 408 Lakeland, FL 33802 863 - 802- 7355/fax 863 - 802 -7814 I PUTNAM Palatka Dally News Legal Advertising P. 0. Box 777 Palatka, FL 32178 386 - 312- 5200Ifax 386 - 312 -6664 I ST. JOHNS I St. Augustine Record Legal Advertising P. 0. Box 1630 St. Augustine, FL 32085 904 - 829- 6562/fax 904- 819 -3559 SEMINOLE Seminole Herald Legal Advertising 300 North French Avenue Sanford, FL 32771 407- 322- 2611/fax 407 - 323 -9408 VOLUSIA News Journal Corporation Legal Advertising P. 0. Box 2831 Daytona Beach, FL 32120 -2831 (386) 740 -4503 /fax (386) 736 -8972 P.- 1 ALA CHUA The Alachua County Record Legal Advertising P. 0. Box 806 Gainesville, FL 32602 352 - 377 -2444 /fax 352 - 338 -1986 BAKER Baker County Press Legal Advertising P. 0. Box 598 Maclenny, FL 32063 904 - 259- 2400/fax 904 - 259 -6502 BRADFORD Bradford County Telegraph Legal Advertising P. 0. Drawer A Starke, FL 32901 904 - 964- 630Stfax 904 - 964 -8628 BREVARD Florida Today, Legal Advertising P. 0. Box 419000 Melbourne, FL 32941 -9000 321- 242- 3500/fax 321 - 242 -6618 CLAY Clay Today, Legal Advertising 1560 Kinsiey Ave., Suite 1 Orange Park, FL 32073 904264 - 3200 /fax 904 -269 -6958 DUVAL Florida Times Union Legal Advertising 1 Riverside Avenue Jacksonville, FL 32202 904359- 4321/fax 904 - 359 -4180 FLAGLER Flagier Tribune, c/o News Journal P. 0. Box 2831 Daytona Beach, FL 32120 -2831 Revised August 27, 2007 H: /pds /data/Holders of General Permits (386) 740 -4503 /fax (386) 736 -8972 INDIAN RIVER Vero Beach Press Journal Legal Advertising P. 0. Box 1268 Vero Beach, FL 32961 -1268 772 - 978- 2214/fax 772- 978 -2340 LAKE Daily Commercial Legal Advertising P. 0. Drawer 490007 Leesburg, FL 34749 352 - 365 - 8230 /fax 352 - 365 -1951 I I Ocala Star Banner, Legal Advertising 2121 SW 19' Avenue Road Ocala, FL 34474 352 - 867 - 4010 /fax 352 - 867 -4126 NASSAU News- Leader, Legal Advertising P. 0. 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Box 2831 Daytona Beach, FL 32120 -2831 (386) 740 -4503 /fax (386) 736 -8972 FORM EN - 44 40C -42, F.A.C. AS -BUILT CERTIFICATION PROJECT NAME: I HEREBY CERTIFY THAT ALL COMPONENTS OF THIS STORMWATER MANAGEMENT SYSTEM HAVE BEEN BUILT SUBSTANTIALLY IN ACCORDANCE WITH THE PERMITTED PLANS AND SPECIFICATIONS. THESE DETERMINATIONS HAVE BEEN BASED UPON ON -SITE OBSERVATION OF THE SYSTEM CONDUCTED BY ME OR BY MY AUTHORIZED AGENT. SIGNATURE NAME (Please Print) T ITLE DATE COMPANY /AGENCY COMPANY /AGENCY ADDRESS CITY, STATE, ZIP CODE TELEPHONE NUMBER WITHIN 30 DAYS OF COMPLETION OF THE SYSTEM, SUBMIT TWO COPIES OF THIS FORM TO: DIVISION OF PERMIT DATA SERVICES ST. JOHNS RIVER WATER MANAGEMENT DISTRICT P.O. BOX 1429 PALATKA, FL 32178 -1429 FORM 40C- 1.181(14) EFFECTIVE 3121193 FORM EN-45 4044, F.A.C. 4OC -42, F.A.C. MSSW /STORMWATER AS -BUILT CERTIFICATION BY A REGISTERED PROFESSIONAL* PERMIT NUMBER: PROJECT NAME: INSPECTION DATE(S): I HEREBY CERTIFY THAT ALL COMPONENTS OF THIS STORMWATER MANAGEMENT SYSTEM HAVE BEEN BUILT SUBSTANTIALLY IN ACCORDANCE WITH THE APPROVED PLANS AND SPECIFICATIONS AND IS READY FOR INSPECTION. ANY SUBSTANTIAL DEVIATIONS (NOTED BELOW) FROM THE APPROVED PLANS AND SPECIFICATIONS WILL NOT PREVENT THE SYSTEM FROM FUNCTIONING IN COMPLIANCE WITH THE REQUIREMENTS OF CHAPTERS 40C-4,40C-41, OR 40C -42, F.A.C. (AS APPLICABLE), WHEN PROPERLY MAINTAINED AND OPERATED. THESE DETERMWATIONS HAVE BEEN BASED UPON ON -SITE OBSERVATION OF THE SYSTEM CONDUCTED BY ME OR BY MY DESIGNEE UNDER MY DIRECT SUPERVISION AND /OR MY REVIEW OF AS -BUILT PLANS CER'T'IFIED BY A REGISTERED PROFESSIONAL OR LAND SURVEYOR LICENSED IN THE STATE OF FLORIDA. NAME (please print) COMPANY NAME COMPANY ADDRESS CITY, STATE, ZIP CODE TELEPHONE NUMBER SIGNATURE OF PROFESSIONAL FLORIDA REGISTRATION NUMBER DATE (Affix Seal) SUBSTANTIAL DEVIATIONS FROM THE APPROVED PLANS AND SPECIFICATIONS: (NOTE: ATTACH TWO COPIES OF AS -BUILT PLANS WHEN THERE ARE SUBSTANTIAL DEVIATIONS) WITHIN 30 DAYS OF INSPECTION OF THE SYSTEM, SUBMIT TWO COPIES OF THIS FORM TO: DIVISION OF PERMIT DATA SERVICES ST. JOHNS RIVER WATER MANAGEMENT DISTRICT P.Q. BOX 1429 PALATKA, FL 32179 -1429 * A REGISTERED PROFESSIONAL IS DEFINED IN SUBSECTION 4OC- 42.021(1) AS "A PROFESSIONAL REGISTERED IN FLORIDA WITH THE NECESSARY EXPERTISE IN THE FIELDS OR HYDROLOGY, DRAINAGE, FLOOD CONTROL, EROSION AND SEDIMENT CONTROL, AND STORMWATER POLLUTION CONTROL TO DESIGN AND CERTIFY STORMWATER MANAGEMENT SYSTEMS ". EXAMPLES OF REGISTERED PROFESSIONALS MAY INCLUDE PROFESSIONAL ENGINEERS LICENSED UNDER CHAPTER 471, F.S., PROFESSIONAL LANDSCAPE ARCHITECTS LICENSED UNDER CHAPTER 481, F.S., AND PROFESSIONAL GEOLOGISTS LICENSED UNDER CHAPTER 492, F.S., WHO HAVE THE REFERENCED SKILLS. EFFE=VE 3/21193 FORM 40C- 1.181(13) FORM EN-46 40C-4, F.A.C. 40C -41, F.A.C. 40C -40, F.A.C. MSSW STORMWATER REGISTERED PROFESSIONAL'S` INSPECTION REPORT PERMIT NUMBER: PROJECT NAME: INSPECTION DATE(S): INSPECTION RESULTS: (CHECK ONE) I HEREBY VERIFY THAT I OR MY DESIGNEE UNDER MY DIRECT SUPERVISION HAVE INSPECTED THE SYSTEM AT THE ABOVE REFERENCED PROJECT AND THAT THE SYSTEM APPEARS TO BE FUNCTIONING IN ACCORDANCE WITH THE REQUIREMENTS OF THE PERMIT AND CHAPTERS 40C-4, 40C -41, OR 40C -42, F.A.C., (AS APPLICABLE). THE FOLLOWING NECESSARY MAINTENANCE WAS CONDUCTED: I HEREBY CERTIFY THAT I OR MY DESIGNEE UNDER MY DIRECT SUPERVISION HAVE INSPECTED THE SYSTEM AT THE ABOVE REFERENCED PROJECT AND THAT THE SYSTEM DOES NOT APPEAR TO BE FUNCTIONING IN ACCORDANCE WITH THE REQUIREMENTS OF THE PERMIT AND CHAPTERS 40C-4, 40C -41, OR 40C -42, F.A.C., (AS APPLICABLE). I HAVE INFORMED THE OPERATION AND MAINTENANCE ENTITY OF THE FOLLOWING: (A) THAT THE SYSTEM DOES NOT APPEAR TO BE FUNCTIONING PROPERLY, (B) THAT MAINTENANCE IS REQUIRED TO BRING THE SYSTEM INTO COMPLIANCE, AND (C) IF MAINTENANCE MEASURES ARE NOT ADEQUATE TO BRING THE SYSTEM INTO COMPLIANCE, THE SYSTEM MAY HAVE TO BE REPLACED OR AN ALTERNATIVE DESIGN CONSTRUCTED SUBSEQUENT TO DISTRICTS' APPROVAL. NAME (please print) SIGNATURE OF PROFESSIONAL COMPANY NAME FLORIDA REGISTRATION NUMBER COMPANY ADDRESS DATE CITY. STATE, ZIP CODE TELEPHONE NUMBER (Affix Seal) WITHIN 30 DAYS OF COMPLETION OF THE SYSTEM, SUBMIT TWO COPIES OF THIS FORM TO: DEPARTMENT OF RESOURCE MANAGEMENT DIVISION OF PERMIT DATA SERVICES ST. JOHNS RIVER WATER MANAGEMENT DISTRICT P.O. BOX 1429 PALATKA, FL 32178 -1429 * A REGISTERED PROFESSIONAL IS DEFINED IN SUBSECTION 40C- 42.021(1) AS "A PROFESSIONAL REGISTERED IN FLORIDA WITH THE NECESSARY EXPERTISE IN THE FIELDS OR HYDROLOGY, DRAINAGE, FLOOD CONTROL, EROSION AND SEDIMENT CONTROL, AND STORMWATER POLLUTION CONTROL TO DESIGN AND CERTIFY STORMWATER MANAGEMENT SYSTEMS ". EXAMPLES OF REGISTERED PROFESSIONALS MAY INCLUDE PROFESSIONAL ENGINEERS LICENSED UNDER CHAPTER 471, F.S., PROFESSIONAL LANDSCAPE ARCHITECTS LICENSED UNDER CHAPTER 481, F.S.. AND PROFESSIONAL GEOLOGISTS LICENSED UNDER CHAPTER 492, F.S., WHO HAVE THE REFERENCED SHILLS. FORM 40C- 1.181(15) EFFE=VE 3/21/93 FORM EN-47 40C-42 F.A.C. STATEMENT OF INSPECTION REPORT PERMIT NUMBER: PROJECT NAME: INSPECTION DATE(S): STORMWATER MANAGEMENT SYSTEM INSPECTION RESULTS: (CHECK ONE) I HEREBY VERIFY THAT I OR MY AUTHORIZED AGENT HAVE INSPECTED THE SYSTEM AT THE ABOVE REFERENCED PROJECT AND THAT IT APPEARS TO BE FUNCTIONING ACCORDING TO THE REQU)REMENTS OF THE PERMIT AND CHAPTER 40C -42, F.A.C. THE FOLLOWING NECESSARY MAINTENANCE WAS CONDUCTED: I HEREBY CERTIFY THAT I OR MY AUTHOR= AGENT HAVE INSPECTED THE SYSTEM AT THE ABOVE REFERENCED PROJECT AND THAT THE SYSTEM DOES NOT APPEAR TO BE FUNCTIONING IN COMPLIANCE WITH THE REQUIREMENTS OF THE PERMIT AND CHAPTER 40C -42, F.A.C. I UNDERSTAND THE FOLLOWING: (A) THAT MAINTENANCE IS REQUIRED TO BRING THE SYSTEM INTO COMPLIANCE, AND (B) IF MAINTENANCE MEASURES ARE NOT ADEQUATE TO BRING THE SYSTEM INTO COMPLIANCE, THE SYSTEM MAY HAVE TO BE REPLACED OR AN ALTERNATIVE DESIGN CONSTRUCTED SUBSEQUENT TO DISTRICT APPROVAL. I WILL CONDUCT THE FOLLOWING MAINTENANCE WITHIN 15 DAYS: SIGNATURE NAME (please print) COMPANY /AGENCY NAME ADDRESS WITHIN 30 DAYS OF INSPECTION OF THE SYSTEM, SUBMIT TWO COPIES OF THIS FORM TO: DIVISION OF PERMIT DATA SERVICES ST. JOHNS RIVER WATER MANAGEMENT DISTRICT P.O. BOX 1429 PALATKA, FL 32178 -1429 DATE PHONE FORM 40C- 1.181(16) EFFECTIVE 3(_'1/93 ST. JOHNS RIVER WATER MANAGEMENT DISTRICT CONSTRUCTION COMIlVIENCEMENT NOTICE ST. JOHNS RIVER WATER MANAGEMENT DISTRICT POST OFFICE BOX 1429 PALATKA, FL 32175 -1429 PROJECT: PHASE: I hereby notify the St. Johns River Water Management District that the construction of the surface water management system authorized by Environmental Resource Permit No. has commencediis expected to commence on 20 , and will require a duration of approximately _ months weeks days to complete. It is understood that should the construction term extend beyond one year, I am obligated to submit the Annual Status Report for Surface Water Management System Construction form no. 40C- 4.900(4). PLEASE NOTE: If the actual construction commencement date is not kriown, District staff should be so notified in writing in order to satisfy permit.conditions. Permittee's or Title and Company Date Authorized Agent's Signature Phone Address Form No. 40C- 4.900(3) EXCEPTIONS REPORT 'FOR STORMWATER MANAGEMENT SYSTEMS OUT OF COMPLIANCE Project Name: Permit Number: Inspection Date(s): Itern(s) Not In Compliance: Proposed Corrective Action(s) to Bring the System Into Compliance: Contact Person: Signature: Address: Phone: Date: Within 14 days of inspection of the system, submit two copies of this form to a local SJRWMD Service Center or: Department of Permit Data Services St. Johns River Water Management District PO Box 1429 Palatka, FL 32178 -1429 District Form No. 40C- 42.900(6)