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... '- P. 0. BO7X BROOKSVILLE, FLORIDA 3.,512
DFRPili.L McATTlE-R., Chairinan Tr..O.fc< rT \s Vs AN UL'R lVEER. Secrclary. YanketomAn RONALD B. i 3 Mi RT. W( uhula
.Z m t. R GRAW. Vice Chairman, CXaka S C tFXLL.E JR land )'Lakes ROBF-R \1i I IN Timp
JCE L. HILL. Treasurer, Leesburg N b -..w S JOHNS, Lakeland \LEWIS H. i c()'lt. R. (I l rwascr
Donald R i-c ser, Exccurive Dircct:r
December 16, 1975
Room 409, Senate Office Building
Tallahassee, Florida 32304
Re: SWFWMD's Amendment to Chapter 16J-0.40 and
16J-2.04, Florida Administrative Code
Dear Mr. Webb:
You will find enclosed proposed simplified Instructions and Consumptive
Use Application Form.
There has been suggestionsfor the Southwest Florida Water Management
District to simplify the Instructions and Application Form applicable
to a Consumptive Use Permit. The permit involved herein is permitted
under Chapter 373.216, etc., Florida Statutes.
A copy of the Notice, Instructions and Application Form is being filed
with your Committee pursuant to Section 120.54, Florida Statutes. Should
you have any questions, please advise.
Very truly yorus,
JY T. AHERN
.c: L. M. Blain, Esquire
SOUTHWEST FLORIDA WATER MANAGEMENT DISTRICT
INSTRUCTIONS AND FORMS FOR COMPLETING THE CONSUMPTIVE USE PERMIT (CUP) APPLICATION
THIS APPLICATION IS FOR ONLY THOSE WATERS WHICH ARE WITHDRAWN FROM THE PROPERTY COVERED
BY THIS APPLICATION. DO NOT INCLUDE ANY WATERS FROM OTHER SOURCES. PLEASE TYPE OR PRINT
IN INK ALL ANSWERS FOR THE CONSUMPTIVE USE PERMIT (CUP) APPLICATION. A WORK SHEET COPY
OF ALL FORMS AND SKETCHES SHOULD BE COMPLETED FIRST IN PENCIL AND RETAINED FOR YOUR RECORDS.
1. Name and mailing address of applicant. The applicant is the individual or the corpo-
'ration who owns, leases or otherwise controls the property. "Local contact" is the
individual who has knowledge of the property, facilities, etc., who may be contacted
for additional information about the application, and who may assist with tagging
2. Property covered by this application. Property "owned" or "leased" are self explan-
atory. "Otherwise controlled" includes any contractual right, rental agreement,
license, or permission from an owner which gives the applicant authority over certain
property, especially insofar as it relates to the water resources of same. County is
that County in which a majority of said property lies.
3. Complete the spaces provided.
4. Complete the spaces provided. If the answer is both, C, be sure to indicate in #9
which are existing and which are proposed facilities.
5. Indicate in the appropriate spaces, the number of points from which water will be
withdrawn. Example: wells 2 ; streams 1 ; lakes or ponds 0 ; other (specify)
0 Total 3 .
6. Indicate by percentage amounts, the proposed uses of the water to be withdrawn; the
total should add to one hundred percent (100%). Individual domestic supply: include
here the total percent which is used for individual personal needs or for household
purposes, such as, drinking, bathing, heating, cooking, or sanitation and for lawns
of less than five (5) acres.
'Provide breakdown of water us, shown in #6 by inserting the b cent of usage in the
appropriate spaces. Complete parts #7a. Public supply; and'#7b. Industrial, if appli-
Complete part #7c. Irrigation, per the following instructions:
/1/ CROP: list each separately. If more than one crop will be raised per year
from the same acreage, indicate the number of crop harvests by placing that
number in parenthesis behind the crop name. Example: strawberries (2).
Pasture, golf courses, and lawns of more than five (5) acres in size should be
listed here as "grass". Fish farming should be listed as "fish".
/2/ PERCENT of total withdrawal is that percentage of the total water withdrawn which
will be applied to the crop on an average yearly basis.
/3/ ACREAGE is the amount of acres used each year for the crop. In most cases,
this will only be a portion of the total lands on the application, unless the
total acreage is under cultivation.
/4/ Irrigation METHOD should be indicated by a letter. Example: "s" for sprinkling;
"f" for flood (ditch) and "d" for drip or trickle.
/5/ Annual hours of OPERATION is the total hours that this crop will be irrigated
during an average year, broken down into day and night time operation. Time re-
quired for moving portable equipment should not be included if the system is not
in operation at that time.
). The amount of water disposed off site for public supply has been shown in #7.
Industrial uses should indicate water disposed off site if the final disposition of
water is into a city sewer or by runoff into a stream or other body of water which
leaves the property. There are some instances in irrigation where water is disposed
off site from ditches. The percent of water so disposed should be reported here.
i. Indicate all withdrawal points on the property whether or not they are in use at the
present time. Standby, fire protection, and any other facility not presently in use
should show the withdrawal as "zero". Proposed facilities should be treated as work-
ing facilities but should be shown as "proposed" by notation of the letter "P" beside
the number. Complete parts #9a and #9b per the following instructions:
The number assigned, column /I/, to either the well, or the intake (drop) pipe, should
agree with the number shown on the location sheet. The diameter, column /2/, is the
diameter of the well casing or the intake (drop) pipe, in inches. The depth of the
well, column a/3/, is to be given in feet measured from the ground surface to the bot-
tom of the hole. The name of the stream, column b/3/, is that formal or common name
associated with the body of water from which water is being withdrawn. If more than
one name is associated with such water, it should be so noted.
The average daily withdrawal, column /4/, is the estimated amount of water to be used
for the year divided by 365. For example: To compute the average daily withdrawal
for irrigation, take the total number of inches of water anticipated to be applied on
an average annual basis; multiply by the number of acres to be irrigated, and multiply
again by 27,154. Finally, divide the entire amount by 365.
Example: 12" average annual to be applied; 40 acres of crop:
1) 12x40 = 480
2) 480x27,154 = 13,033,920
3). 13,033,920-365 = 35,710 gallons/day
The maximum daily withdrawal, column /5/, is that amount of water which would be pumped
during a 24 hour period of maximum withdrawal. To compute the maximum daily withdrawal,
take the amount of water withdrawn in a minute; multiply by 60 to get withdrawal/hour
and multiply again by the number of hours that the system would be operated on the longest
Example: Portable gun which delivers 550 gallons/minute and runs 14 hours
1) 550 x 60 = 33,000 gallons/hour
2) 33,000 x 14 = 462,000 gallons/ day maximum
10. Affidavit of Ownership: The Rules and Regulations of the Southwest Florida Water
Management District require that adjacent property owners be listed by the applicant
for notification concerning any large withdrawal of water in their immediate area.
In special instances when the permit is for a continuing use of water and when there
Is an inordinately large number of persons to be notified, it is possible to get a
waiver of affidavit by making application to the Board for such a waiver. Forms
for waiver of affidavit will be furnished upon request. The application for waiver
will be presented to the Board at its regular monthly meeting. If approved, the
waiver may be used in place of the Affidavit of Ownership, and should be submitted
with this application. The applicant is required to complete an Affidavit of Owner-
ship form along with this application or submit a waiver.
Complete the form as per instruction thereon.
11. Complete the Withdrawals Location Sketch as indicated.
'2. Complete the Property Location Map as indicated if required.
INCLUDE WITH THIS COMPLETED APPLICATION:
1. An affidavit form properly completed or a letter of waiver if one has been received.
2. A check or money order in the amount of $10.00 made payable to Southwest Florida
Water Management District.
3. All separate information sheets which have been added as well as any other pertinent
information which will assist in the processing of your application.
4. Mail all to the Southwest Florida Water Management District, P.O. Box 457, Brooksville,
Florida 33512 in the envelope as furnished with the application forms.
SOUTHWEST FLORIDA WATER MANAGEMENT DISTRICT
CONSUMPTIVE USE PERMIT APPLICATION
?lease TYPE OR PRINT IN INK.
(city & state) (zip) (telephone) (area code)
(name) (telephone) (area code)
2. Describe PROPERTY covered by this application : Location -
Indicate amount of acreage to nearest 1/10 of an acre: owned ; Leased ;
otherwise controlled Total
3. Is this application for (check one) renewal? yes no ; or modification of a
current Consumptive Use Permit (CUP)? yes no .' If yes, give the CUP
4. The withdrawal of all water covered by this application:
a. Existed prior to January 1, 1975: yes no ;
b. Withdrawal began or will begin
c. Both of the above: yes no
5. Indicate the number of withdrawal points for this application:
wells __, streams ___ lakes ponds ___ other (specify)
6. What percent (%) of water withdrawn will be used for the following purposes?:
(If "Zero", so indicate)
a. public supply ; b. industrial ; c. irrigation ; d. individual domes-
tic supply ; e. other (specify) Total. (should equal 100%).
7. Provide breakdown of uses as listed in #6; enter percent of total for:
a. Public supply by disposal method: individual septic tank %, on site perco-
lation and ponding %; on site spray irrigation %; off site
disposal of treated sewage %; other (specify) %. Sub-total
#7a % (should agree with #6a above).
b. Industrial: Mining; phosphate %; limerock %; sand/gravel %;,
other (specify %.
Processing/refining: phosphate %; limerock %; sand/gravel
%; other (specify) %.
Perishable food processing %;
Power companies (make up) %; other (specify) %.
Sub-total #7b % (should agree with #6b above).
/1/ /2/ /3/ /4/ /5/
CROP (list each separately) PERCENT (total ACREAGE METHOD* OPERATION hours)
(see instruction #7) withdrawal) s,f, or d day night total
Sub-total #7c (should agree with #6C above).
*METHOD: "s" for sprinkling; "f" for flood (ditch): and "d" for drip or trickle.
Will any part of the water withdrawn, for use other than public supply, as shown in #6
above, be disposed off site? yes no Indicate the total percent so disposed:
Indicate all withdrawal points on the property whether or not they are in use at the
present time. Standby, fire protection, and any other facility not presently in use should
show the withdrawal as "zero". Proposed facilities should be treated the same as work-
ing facilities but should be shown as "proposed" by notation of the letter "P".
a. Withdrawal from WELLS: assign a number in column /1/ to each well and enter data
for each well in columns /2/ through /5/. The number assigned to each well must
agree with the number on withdrawal sheet (#11).
Do not write in this space /i/ i /2/ /3/ 1 Withdrawal-gallons/day
(for office use only) No. Diam. Depth Average Maximum
(for office use only) No. Diam. Depth Average Maximumm
If additional space is needed, add a separate sheet.
141 151 |
AFFIDAVIT OF OWNERSHIP FORM
3. List below, as per the following tables, the name and address of each property owner
within the prescribed distance. Encircle the distance as used. The District assumes
the responsibility of noticing the list of adjacent property owners as provided by
If water greater then 100,000 gallons per day is to be withdrawn from a well or
combination of wells, all property owners within the following indicated distances
from the well, or (at the option of the applicant) from the property boundary on
all sides, must be listed:
Withdrawal amounts Distance Distance from
,average gallons/day from Well property boundary
under 100,000 Notice not required, however, the Affidavit of Ownership form must
be marked NA (not applicable) and returned with the CUP application.
100,000 to 500,000 660 feet 100 feet
500,000 to 1,000,000 1,320 feet 200 feet
1,000,000 and above 2,640 feet 400 feet
If water is to be withdrawn from a body of SURFACE WATER list adjacent owners according
to the following schedule:
Withdrawal amounts Distance Distance from
average gallons/day upstream downstream property boundary
any amount from any
impoundment of less all property owners along the shoreline
than 80 acres within 660 feet in each direction
5,000,000 or less 660 1,320 same
over 5,000,000 1,320 2,640 same
If additional space is needed, add a separate sheet. Failure to list all property
owners and their correct addresses may result in the delayed processing of your
Signature of Applicant
1n. WITHDRAWALS) LOCATION SKETCH
Below is a map of one section of a township divided into 1/4 1/4. Please
complete a sketch for every section of property covered by this application
which has one or more withdrawal points (well or intake pipe), showing the
exact location of the points as accurately as possible. Locate all withdrawal
points whether or not they are in use if they are covered by this application.
Numbers assigned to these withdrawal points must agree with the numbers shown
in item #9 on the CUP application form.
If all of the property covered by this application is in one section, sketch the
outline of said property on this sheet.
If the property covered by the application is in more than one section of property,
complete the enclosed PROPERTY LOCATION IAP (item #12).
Section Township South Range East
NW 1/4 of NW 1/4 NE 1/4 of NW 1/4 NW 1/4 of NE 1/4 NE 1/4 of NE 1/4
NW 1/4 NE 1/4
SW 1/4 of NW 1/4 SE 1/4 of NW 1/4 SW 1/4 of NE 1/4 SE 1/4 of NE 1/4
40 acres 20a-------
Scale 1" = 660 /eet (1/8 mile)
Scale 1" = 660 feet (l/8 mile)
12. PROPERTY LOCATION MAP
Each block in the illustration below represents a section of a township. If the
property covered by this application covers more than one section, please draw a
sketch of the property boundaries on this sheet.
One section has been divided to show the proportionate size of a plot.
Number the sections to agree with your property.
If you need more sections than the sixteen(16) available here, add a separate sheet
with the appropriate illustration thereon.
80a (1 Square Mile)
Scale 1" = 2640 feet (1/2 mile)