665-St. Johns-Mill Creek Permit
ST. JOHNS RIVER WATER MANAGEMENT DISTRICT
CONSTRUCTION COMMENCEMENT NOTICE
ST. JOHNS RIVER WATER MANAGEMENT DISTRICT
POST OFFICE BOX 1429 - -
PALATKA, FL 32178-1429
PROJECT: PHASE: '
I hereby notify the St. Johns River Wa~er Management District that the construction of the
surface water management system authorized by Environmental Resource Permit No.
has commenced/is expected. to commence on
199 , 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 n6t known, 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
b, Johns River Water Management District
Annual Status Report for
Surface Water Management Systems Construction]
(Required whenever construction duration exceeds one ( 1 ) year)
ST, JOHNS RIVER WATER MANAGEMENT DISTRICT
P,O. Box 1429
Palatka, FL 32178-1429
PERMIT NO.
PROJECT NAME: PHASE:
Control Structurefs'~ % of Completion Date of Anticioated Dam of
Comeletion Completion
Benchmark Description (one per major control stn~cture)
Surface Water Mgt. % of Completion Date of Anticipated Date of
WOrks Comoletion Completion '
Lake(s)
Ditch(es)
/Swale(s)
Ex~ltr. Trench
Dry Area(s)
Betre(s)
Print Name Phone
Permittee's or Authorized Title and Company Date
Agent's Signature