INDIVIDUAL WATER USE PERMIT APPLICATION
SOUTHWEST FLORIDA WATER MANAGEMENT DISTRICT
2379 BROAD STREET BROOKSVILLE, FL 34609-6899. (904)796-7211 or FLORIDA WATS 1(800)423-1476
(SEE LAST PAGE OF THIS FORM FOR YOUR LOCAL PERMITTING OFFICE)
USE FOR QUANTITIES OF
500,000 GALLONS PER DAY OR GREATER 0 0 0 0 3 0 2
THIS FORM MUST BE COMPLETED FOR ALL APPLICANTS REQUESTING ANNUAL AVERAGE QUANTITIES OF
500,000 GPD OR GREATER. OTHER APPLICANTS MUST COMPLETE THE APPLICATION FORM CORRESPONDING
TO THE PROPOSED QUANTITY. THIS INFORMATION IS REQUESTED IN ACCORDANCE WITH RULES 40D-2.101
AND 40D-2.301, FLORIDA ADMINISTRATIVE CODE.
'AN ASTERISK IDENTIFIES ITEMS TO BE INDICATED ON SITE MAP; YOU MAY USE THE MAP REQUESTED IN ITEM
IV, SECTION B OF THE WUP APPLICATION.
PLEASE SUBMIT THREE COPIES OF THIS APPLICATION ALONG WITH THREE COPIES OF THE
APPROPRIATE SUPPLEMENTAL FORM (IF REQUIRED), DRAWINGS, CALCULATIONS, ETC.
1. Type of Application (Check One): 0 New I1 Renewal Q Modification
2. Water Use Permit Number (If application is for renewal or modification): 200003.01 (Section 21 Wel field)
NOTE: "Applicant" is the name under which the permit will be issued (examples: Robert Jones; Baker Groves, Inc., Acme
Industries, City of Sundale.) All correspondence will be addressed to the ap licant unless an alternate contact is requested
in Item 4.
NAMECity of St. Petersburg/ est st e egiia Water 'TELEPHONE (813 )996-2835
ADDRESS 2535 Landmark Dr., Suite 211 COUNTY Hillsborough
CITYSTATEZIP Carwatr FL 321 i f St. Petersburg on all correspondence
Applicant is: 0 Owner 0 Lessee Q Other
4. CONTACT OR CONSULTANT Address all correspondence to the person Identified below? i Yes E] No
NAMEWest Coast Regional Water Supply Authority Attn: R. Warren Hogg, Proj. Hydrologist
ADDRESS 2535 Landmark Dr., Suite 211 TELEPHONE (81 ) g-PR3
CITY,STATE,ZIP Clearwater, FL 34621 (copy City of St. Petersburg on all correspondence
5. OWNER (IF OTHER THAN APPLICANT) address be ow)
NAMECity of St. Petersburg Attn: William Johnson, Public Utilities Dept. Director
ADDRESS 1635 3rd Aenue North TELEPHONE (81 kZ-
CITY,STATE,ZIP St. Petersbur FL 33713 4"04
1. Provide a legal description of the property served by this application. W Attached Attachment .I. r
2. This property is: 0 Owned by the applicant 0 Leased by the applicant 0 Applicatioas oh ,tea t ,.
Attachment 11.2. ,'
3. Leased property: Provide a copy of either (check type of document that is attached): N/A 1 .-2roo
I Copy of lease 0 Letter signed by the property owner describing the lease arrangement and the duration o
NOTE: Permits will not be issued for a duration longer than the lease, unless the lease is renewable. If renewable, the
applicant may be required by Permit Condition to provide a copy of the renewed lease at the appropriate.tije.iTJ propertyy
owner and the lessee must sign this application in Section VII.
4. Other Legal Control: If the applicant has legal control over the property other than a lease agreement, please provide a
description on an attached sheet 0 Attached 0 N/A
WUP-3 Form 46.20-003 (12/89) PAGE 1 01- b
PAGE 1 OF 6
WUP-3 Form 46.20-003 (12/89)
SECTION A Quantity
1. Annual average quantity applied for, in gallons per day (gpd), This quantity should reflect the amount needed six years
and ten years hence, or for the remainder of permit duration, if the application is for a modification:
6years:12000,000 pd) 10years: 12,000,000(gpd) XtK,12,000,000 (gpd)
2. Indicate the requested peak monthly pumpage quantity. See Section 3 of the Basis of Review for an explanation of this
6 years 16. 000.000 (gpd)
10 years 16.000.OQ O (gpd)
SECTION B Water Use
3. Indicate all that apply. Information Supplements must be filled out for all uses. See Section 3 of the Basis of Review for
explanations of the use classifications.
p Public Supply [ Recreation or Aesthetic Q Agricultural
SIndustrial or Commercial I Mining or Dewatering
4. Indicate the date on which the use of water was initiated or is proposed for initiation (month/day/year): Feb. 1963
5. Indicate the quantity and source of any reuse water used by the applicant: St. Petersburg Water
Annual Average Quantity20 550. 000gpd; Peak Month Quantity 26, .64, 00lpd; Source: 'Reclamation Faci li ti
SECTION A Acreage
1. Number of acres Owned: 584 ; Leased: N/A ; Serviced 50. 726 ,
2. Describe the location of the property contained in thie application by Section, Township, Range, 1/4 Section:
Section 21 Township 27S Range 18E 1/4 Section
(Portion of Section. Less the Southeast 1/4 of the Southwest 1/4)
SECTION B Location Maps
3. Provide a recent aerial map showing: (a) a north arrow; (b) a scale designation all maps should have a minimum
scale of 1"= 2,000'; (c) landmarks such as roads and political boundaries; (d) property boundaries include approximate
lengths of boundaries in feet; (e) withdrawal point locations label withdrawal points, indicate the distance from the with
drawal points to the nearest property boundaries in feet, *(lf the withdrawal points are located on non-contiguous
parcels, provide separate large-scale maps in addition to a large-scale map which includes all parcels); (f) the area
serviced or irrigated, *(if the area serviced or irrigated is a distance from the withdrawal locations, provide separate
*May require separate or additional maps.
See Attachment IV.B.3.
4. Use a Map (not necessarily an aerial) or a sketch of the applicant's property and surrounding area to indicate:
a. Approximate location of other wells not owned by the applicant including domestic wells, irrigation wells, public water
supply wells, etc. within the distance set forth in Item 5, Table 1, below. Supplemental locations at a greater distance
mayberequired. See Attachment IV.B.4.a,b
b. Location of monitoring wells, including reference numbers. See Attachment IV.B. 3
c. Wetlands greater than 0.5 acre in size, covering the area within the distance set forth in Item 5, below.
Substantial off-site drawdown impacts may require additional aerial coverage. Mining applicants requirements differ,
and are provided on the Mining and Dewatering Supplemental Form, Form No. WUP-6. See Attachment IV.B.3
SECTION C Adjacent Property Owners
5. Submit a listing of the names and mailing addresses of property owners near the property contained in this application,
based on the quantity to be withdrawn and the table provided below. You may choose a distance from either your
property boundary or your withdrawal point. The District may require additional potentially affected property owners to be
submitted. Attachment C.5 Section C, Item 5 continued on Page 3
See Attachment I V. C. 5 Section C, Item 5 continued on Page 3
WUP-3 Form 46.20-003 (12/89)
t PAGE 2 OF 6
Section t, Item 3 continued from Page 2
TABLE 1 FOR WELL OR MINE PIT WITHDRAWALS OF:
Average GPD on OR Maximum GPD During
an Annual Basis Any Single Day
Provide Information on the Following:
500,000 gpd but
less than 1,000,000
1,000,000 gpd or
More than 5,000,000
but not more than
More than 10,000,000
All property owners within 1,320' of the well, or within 200'
ofyourpropertyboundary 20000 3 02
All property owners within 2,640' of the well, or within 400'
of your property boundary
TABLE 2- FOR SURFACE WATER WITHDRAWALS:
If your withdrawal is from a lake with a surface area of 80 acres or less, list below all riparian owners on the lake or
If your withdrawal is from a lake larger than 80 acres, list below all riparian owners in either direction 660' from point
where applicant's property intersects the shoreline.
If your withdrawal is from a stream and if the maximum daily average pumpage is less than 5,000,000 gpd, list below
all riparian owners 660' upstream and 1,320' downstream from your property boundaries at the shoreline.
If your withdrawal is from a stream and if the maximum daily average pumpage is greater than or equal to 5,000,000
gpd, list below all riparian owners 1,320' upstream and 2,640' downstream from your property boundaries at the
Name Mailing Address
Section D Withdrawal Points
6. Groundwater Withdrawals. Include all wells on property greater than 2" in diameter, whether active or inactive, and
whether existing or proposed, in the table on the following page: ...
TABLE SWFWMD I.D. No. the withdrawal number assigned by the District, if existing.
LEGEND: Owner I.D. No. the owner's I.D. number.
Construction Date the approximate date that withdrawal point became operable. -
Average Withdrawal Rate the total quantity of water to be withdrawn in one year divided by 365.
Peak Monthly Withdrawal Rate the maximum quantity to be withdrawn in a single month.
Maximum Daily Withdrawal Rate the maximum quantity to be withdrawn in any single day. '" -'r:. t.
Standby refers to status of wells that would not be used unless another well becomes inoperable.
Cap the well is capped.
Meter refers to whether a flow meter is installed: if several withdrawals are connected to the same meter
(ganged), indicated by placing a letter character (a, b, etc.) instead of a check mark, linking those intercon-
nected withdrawals by like characters.
Monitor refers to water level or water quality monitors. Indicate the type of monitor by placing an L ("Level") O
("Quality"), or both in the space provided. The absence of checkmarks or letters indicates active status.
Mainline Diameter refers to the outside diameter of the main discharge pipe.
Proposed check if the withdrawal point is proposed rather than existing. Section D, continued on Page 4
WUP-3Section D, continued on Page 4
PAGE 3 OF 6
WUP-3 Form 46.20-003 (12/89)
Section D. continued from Page 3
ID No. ID No. Diameter Total Depth Construction Pump Withdrawal Rate Status (check): Mainline
SWFWMD Owner Depth Cased Date Capacity (gpm) Average Annual Peak Month proposed Mon. Stdby. Cap. Met. Diameter
See Table IV.D.6 __
7. Indicate the future use of any capped source: N/A
8. Indicate the parameters sampled for any monitor wells listed above: Chl ride, t 1l fate, TDS concentrations,
conductivity pH, temperature
9. Surface Water Withdrawals See the Groundwater withdrawal section above for explanation of most terms. Source
name is the name of a lake, stream or other waterbody
ID No. ID No. Source Lake Intake Punp Withdrawl Rate Status (check): Mainline
SWFWMD Owner Name Acreage Diameter Capacity (gpm) Average Annual PeaMoth Proposed Actie Sdby. Metered Diameter
N/A__________________ ____ ________ ____ Average Anual_ Pea-Mohet td
10. Other Sources Describe any other sources of water, such as from utilities, treated waste water effluent, etc. List
annual average and peak month quantities for each additional source: See Attachment IV.D.10
SAre you aware of any adverse impacts that your withdrawals have or may have on other water users, offsite land uses, the
water resources, or environmental features? If so, provide a detailed explanation of the impact and your plans to deal
None Anticipated I0 Explanation Attached 0
See Attachment V.
Provide any information available on regional and site-specific hydrogeology, including aquifer characteristics, for all
aquifers existing in the area of your withdrawals. Provide documentation and references in support of this information. If
you do not have such information, hydrogeologic testing may be required either as additional information in support of
your application, as a condition of the permit, or both. The District may use appropriate regional data in lieu of or in
addition to submitted information to assess the impacts of your withdrawals. New hydrogeologic testing should follow the
guidelines of Part C, Permit Information Manual.
See Attachment VI.
Y- PAGE 4 OF 6
........----------.----------..-~.. .. .--. -- .-....-_. -. --. ..... .....~ .,
WUP-3 Form 46.20-003 (12/89)
-... V-.. _.A__-__ _" __'"__,__._T .__.__. .... ....C A...
I hereby certify that the information contained herein is true and accurate and that I have legal authority to undertake the
activities described herein and execute this application.
I hereby certify that the applicant
in this application.
Attachments requested in support of this application: Attached N/A
1. (Section II-1)Copy of Legal Description d 0
2. (Section 11-2)Copy of Current Lease 0
3. (Section 11-3)Description of Other Legal Property Control 0
4. (Section IV-3)Aerial Map 0 0
5. (Section IV-4)Site Map W Q
6. (Section IV-5)Adjacent Property Owners Q
7. (Section VI)Hydrologic Information Q
8. Appropriate Supplemental Form 0 Q
WUP- For 46.0.00(1219) PGE 5OF
__ __ __
WUP-3 Form 46.20-003(12/89)
PAGE 5 OF 6
BROOKSVILLE PERMITTING DEPT. c
2379 Broad Street
Brooksville, Florida 34609-6899
Phone (904) 796-7211
TAMPA PERMITTING DEPT. ]
7601 U.S. Hwy. 301
Tampa, Florida 33637
Phone (813) 985-7481
BARTOW PERMITTING DEPT. j
970 East Main, Suite A
Bartow, Florida 33830
Phone (813) 534-7080
VENICE PERMITTING DEPT.
111 Corporation Way
Venice, Florida 34292
Phone (813) 488-4666
* Disri Service Office Locaion
Permit applications for water use, surface water management, and well construction
maybe submitted to any district service office. Permitting evaluation and field
services for projects within thedesignated areas will be conducted by the appropriate division.
WUP-a Form 46.2-003(12/89) G .. .
WATER USE PERMIT APPLICATION SUPPLEMENTAL FORM
SSOUT IWESTFLORIDA WATER MANAGEMENTDISTRICT
.4 2379 BROAD STREET BROOKSVILLE, FL 34609-6899 (904)796-7211 or FLORIDA WATS 1(800)423-1476
ANSWER ALL QUESTIONS. IF A QUESTION IS NOT APPLICABLE, ENTER N/A. IF MORE SPACE IS NEEDED,
ATTACH ADDITIONAL SHEETS AND REFER TO THE APPLICATION QUESTION NUMBER. PROVIDE DOCUMENTATION
AND REFERENCES WHERE APPROPRIATE. IF THERE ARE OTHER USES, COMPLETE THE APPROPRIATE
SUPPLEMENTAL FORM(S). THIS INFORMATION IS REQUESTED IN ACCORDANCE WITH RULES 40D-2.101 AND
40D-2.301, FLORIDA ADMINISTRATIVE CODE.
*AN ASTERISK IDENTIFIES ITEMS TO BE INDICATED ON SITE MAP; YOU MAY USE THE MAP REQUESTED IN ITEM IV,
SECTION B OF THE WUP APPLICATION.
PLEASE SUBMIT THREE COPIES OF THIS SUPPLEMENTAL FORM ALONG WITH YOUR APPLICATION,
DRAWINGS, CALCULATIONS, ETC.
APPLICANT: City of St. Petersburq/ et Cgast.Reainal.
(Same as shown on WUP application) Lur
WUP No.(If Existing): 200003.01
(Section 21 Wellfi ld
SECTION A Wastewater Treatment
1. Describe existing and proposed wastewater treatment plants and major treated effluent transmission lines within the
area serviced; include DER rated capacity, potential capacity, disposal area, and method of treatment.
See response to WUP Application Item III.B.5 and Attachment II.A.1 (Public Supply
SECTION B Fire Flow
2. Describe fire flow and standby capacity. SPP Attarhmpnt. TT .R.
SECTION C Wellfield Operation Schedule
3. Describe the typical wellfield operation schedule. Include in the
(peaking), stand-by and the well rotation schedule, if any. See /
SECTION D Surface Water Management
4. Is a surface water management system proposed? Yes 0 No Q ; existing? Yes 0 Permit No. .No M
If "yes," provide an evaluation of the impact of the proposed withdrawal on the surface water system, and conversely, the
impact of the surface water management system on the withdrawal and water availability at the project site must be
submitted. 0 Attached Q N/A
WUP-7 Form 46.20.007 (12189) PAGE 1 09- 4
PAGE 1 OF 4
WUP-7 Form 46.20-007 (12/89)
SECTION A Annual Average Quantities In Gallons Per Day (gpd)
The applicant may supply the following information divided into wholesale and retail categories, or may combine them. If the
quantities are divided, the two categories must be totalled.
Present Projected Projected
6 Year 10 Year
1. Residential Single-Family See Table II .A/B 6 Year 10 Year
2. Residential Multi-Family
3. Other Metered Uses
4. Other Uses (gpd)
5. TOTAL AVERAGE WATER USE (GPD) I I I
SECTION B Other Uses (Itemized)
You must complete this section if the Other Use quantity in Section A exceeds 15%. Please provide calculations and refer-
ences for each component identified below. If the other use quantity in Section A is 15% or less, you are not required to
complete this section but may do so, at your option.
6. Commercial/Industrial non-process See Table III.A/B
7. Commercial/Industrial process
8. Recreation Irrigation
9. Fire Fighting (testing, etc.)
10. Water Utiliity Use
11. Treatment Losses
12. Unaccounted Use
13. TOTAL OTHER USES (Enter on Line 4, above)
SECTION C Recreation Irrigation
14. If any of the projected water use will be for irrigation of golf courses or recreational areas (excluding residential lawns and
landscaping), respond to items a through c below. If these quantities are greater than 100,000 gpd average annual, you
must fill out the Recreational Supplemental Information form.
a. Type(s) of vegetation to be irrigated N/A
b. Area in acres which will be irrigated, for each type of vegetation (include on map)
c. Type of Irrigation System(s)
SECTION D- Seasonal Fluctuations
15. If a significant seasonal and/or tourist population is experienced, describe how this influences per-capita water use.
See Attachment III.D.15
SECTION E Peak Month Quantity (gpd)
Present Projected Projected
6 Year 10 Year
16. Provide the quantity needed in the peak month not on permit 16,000,000 16,000,000
17. Provide documentation and calculations for these quantities. [ Attached Projected 20 year
') .PAGE 2 OF 4
WUP-7 Form 46.20-007 (12/89)
SECTION A Deslination
1. If your system includes desalination, indicate the following:
a. Withdrawal capacity. N/A apd
b. Potable water supply capacity. apd
c. Reject water discharge capacity. pd 2 0 0 0 3 08
d. Treatment efficiency ratio (ratio of treated water to reject):
e. Amount of raw water that can be blended with the R.O. permeate: qgpd
f. Highest level of total dissolved solids (TDS) or chlorides that can be efficiently and economically treated using the
installed membranes. mg/l
g. Chloride ion concentration in rejected water: mg/l and receiving water body: mg/I
h. Location of effluent discharge on a map.*
SECTION B Aquifer Storage Recovery
2. If Aquifer Storage Recovery is used, describe the operation of this system(use separate sheet if necessary).
1. If regulated by the Public Service Commission, indicate the certificate number of each Public Service Commission
certificate, provide a copy of the description of the certificated service area and provide a map of the certificated area.
Certificate No. Description/map attached 0 N/A L
2. Describe legal rights or intent of acquisition for proposed well or wellfield sites. N/A
3. Is the wellfield protected by a Wellfield Protection Ordinance? Yes MB No 0 If "yes," provide a copy of the
Ordinance, and discuss whether the proposed water use will affect existing land uses as a consequence of the Ordinance.
See Attachment V.3
SECTION A- Wholesale Users:
1. List all wholesale customers served by this application, and specify the percentage of each customer's total demand and
the quantity that is supplied by this application.
Customer name and mailing address: % Qu (gpd) O/
Ann -vg. Peak Month
See Attachment VI.A.1. ____
SECTION B Distribution, Wholesale and Retail,
2. Population Served
3. Per-capita use (gpd/person)
4. Finished Water Storage Capacity (gallons)
5. Acreage Serviced Retail
6. Acreage Serviced Wholesale
WUP-7 Form 46.20-007 (12/89)
Present Projected Projected
6 Year .:' .iOYear ..Y..
See Attachment VI.B. 2-6 ___e.
PAGE 3 OF 4-
PAGE 3 OF 4
*SECTION C Maps Pertaining to Service (You may use the map requested in Item IV, action B of the application
form, if appropriate)
7. Provide a map or maps of the area supplied including outlines of the current Service Area(s), Wholesale Area(s), and
projected Service Area(s) and Wholesale Area(s) for a minimum time equal to the duration of the permit. Indi-
cate locations of the following items on the map(s), as applicable:
a. water withdrawal sites;
b. water level and water quality monitoring sites; See Attachment VI.C.7. and WUP Application Item IV. 1.3.
c. raw water treatment facilities and wastewater disposal or discharge sites;
d. major water transmission mains, including existing, planned, and potential intersystem connections;
e. wastewater treatment sites and treated wastewater transmission facilities (including major transmission lines and
f. any proposed construction associated with measures referenced in the required water conservation plan for public
supply systems of 500,000 average gpd or greater;
g. water storage facilities;
h. major landmarks, such as roads, rivers, and lakes.
All maps must include a north arrow and have the scale indicated. A legend must be provided to define any symbols not
otherwise identified. If any of the required information is located beyond the limits of the service area map(s), provide addi-
tional maps as needed to locate the remaining items. Include a separate map if the withdrawal locations are not continuous
with the area served, or if the well parcels are not on contiguous owned/controlled property. All maps should be of a scale of
1" = 2000' or larger, however other scales may be accepted.
8. Provide written agreements from all wholesale water purchasers stating that they will abide by the terms and conditions
of the permit. I3 Attached 0 N/A See Attachment VI.C.8.
9. Provide a letter indicating that the local government has adopted provisions for the enforcement of the Water
Conservation Act, Section 553.14, F.S. 1D Attached o N/A See Attachment VI. C.9.
Attach a description of water conservation practices currently employed or planned. If planned, include an estimated
time-frame for implementation. O1 Attached See Attachment VIII.
WUP7*or 4--.20-07-(12/9)--PAGE 4 OF 4
WUP-7 f-orm 46.20-007 (12/89) PA 4