Nexus
Nexus
Nexus
✔ Individual permit for a domestic wastewater collection/transmission system serving 10 or greater equivalent dwelling units
(EDU). An EDU is equal to 3.5 persons. Criteria for an individual permit are contained in Rule 62-604.600(7), F.A.C.
Application fee: $500
Individual permit for a domestic wastewater collection/transmission system serving less than 10 equivalent dwelling units
(EDU). An EDU is equal to 3.5 persons. Criteria for an individual permit are contained in Rule 62-604.600(7), F.A.C.
Application fee: $300
Notice of Intent to use the general permit for a domestic wastewater collection/transmission system. Criteria for a general
permit are contained in Rule 62-604.600(6), F.A.C. Projects not meeting the criteria in Rule 62-604.600(6), F.A.C., must apply for
an individual permit.
Application fee: $250
*Note: Each non-contiguous project (i.e., projects that are not interconnected or are not located on adjacent streets or in the same neighborhood) requires
a separate application and fee.
Subpart B: Instructions
(1) This form shall be completed for all public and private domestic wastewater collection/transmission system construction projects asfollows:
x If this is a Notice of Intent to use the general permit, this notification shall be submitted to the Department at least 30 days prior to
initiating construction.
x If this is an application for an individual permit, the permit must be obtained prior to initiating construction.
(2) One copy of the completed form shall be submitted to the appropriate DEP district office or delegated local program along with the appropriate
fee, and one copy of the following supporting documents. Checks should be made payable to the Florida Department of Environmental
Protection, or the name of the appropriate delegated local program. Forms and documents may be submitted electronically in accordance with
the Wastewater Electronic Document Submission instructions available from DEP’s website.
x If this is a Notice of Intent to use the general permit, attach a site plan or sketch showing the size and approximate location of new or
altered gravity sewers, pump stations and force mains; showing the approximate location of manholes and isolation valves; and showing
how the proposed project ties into the existing or proposed wastewater facilities. The site plan or sketch shall be signed and sealed by a
professional engineer registered in Florida.
x If this is an application for an individual permit, one set of plans and specifications shall be submitted with this application. The plans and
specifications shall include lift station design calculations if a lift station is proposed. Chapters 10 and 20 of Recommended Standards for
Wastewater Facilities, 2014, provide helpful guidance on the proper preparation of plans and specifications. The plans and specifications shall
be signed and sealed by a Professional Engineer registered inFlorida.
(3) All information shall be typed or printed in ink if submitting paper forms. Where attached sheets (or other technical documentation) are utilized
in lieu of the blank spaces provided, indicate appropriate cross-references on the form. For Items (1) through (4) of Part II of this application
form, if an item is not applicable to your project, indicate “NA” in the appropriate spaceprovided.
DEP Form 62-604.300(3)(a), Notification/Application for Constructing a Domestic Wastewater Collection/Transmission Page 1
System Incorporated by reference in subsection 62-604.300(3), F.A.C., (KĐƚŽďĞƌϰ͕ϮϬϮϭ)
DocuSign Envelope ID: 0D4398AD-8955-4347-AA6B-F4523C4F1179
JIM KERN
Name _______ MANAGER
______________________________________ Title _________________________________________________
GO LIFE HOLDING, LLC
Company Name ___________________________________________________________________________________________
1550 MADRUGA AVENUE, SUITE 130
Address _________________________________________________________________________________________________
CORAL GABLES
City ________ FL _______ Zip __________________
_______________________________________ State ____ 33416
305-717-1800
Telephone _______________________________ Cell______________________________ Fax ___________________________
jimkern@thekerncompany.com
Email ___________________________________________________________________________________________________
(2) General Project Information
VENETIAN GROVE - PHASE 1
Project Name ______________________________________________________________________________________________________
9400 8TH STREET
Project Address ____________________________________________________________________________________________________
VERO______________________________________________
City ______ BEACH FL _______________________ Zip __________________
State ____ 32966
INDIAN RIVER
County ___________________________________________ 27.621553
Latitude ___ 80.527348
__________________ Longitude ______________________
Project Description and Purpose (including the total length and material of each diameter of proposed gravity sewers and forcemains, total
number of manholes, total number of pump stations, and connections to existing system):
VENETIAN GOVE - PHASE 1 IS A 251 UNIT RESIDENTIAL SUBDIVISION WITH CLUBHOUSE THE
FOLLOWING SEWER UTILITIES: 1 OF PUBLIC LIFT STATION, 6,658 LF 8" PVC GRAVITY SEWER, 1,320 LF
6" PVC FORCE MAIN, 25 MANHOLES, 125 LF 6" HDPE FORCE MAIN, 1 AIR RELEASE VALVE, 4 OF 6" GATE
VALVES, 1 OF 6" X 8" TAPPING SADDLE
Type of Unit Number of Units Population Total Per Capita Total Average Daily Peak hour flow
Per Unit Population Flow in Gallons Flow in GPD in Gallons Per
(Number of Units per Day (GPD) (Total Population x Minute (GPM)
x Population Per Per Capita Flow)
Unit)
Single-Family Home 251 2.5 627.5 100 62750 108.9
Mobile Home
Apartment
Commercial, Institutional,
or Industrial Facility* 3 2.5 7.5 100 750 1.3
Total NA NA NA
63500 110.2
* Description of commercial, institutional, and industrial facilities and explanation of method used to estimate per capita flow for these
facilities:
DEP Form 62-604.300(3)(a), Notification/Application for Constructing a Domestic Wastewater Collection/Transmission Page 2
System Incorporated by reference in subsection 62-604.300(3), F.A.C., (KĐƚŽďĞƌϰ͕ϮϬϮϭ)
DocuSign Envelope ID: 0D4398AD-8955-4347-AA6B-F4523C4F1179
A. This information must be completed for all projects by the applicant’s professional engineer, and if applicable, those professional engineers
in other disciplines who assisted with the design of the project. The checklist below shall be used for conventional collection/transmission
systems while Attachment I to this form shall be used for low pressure sewer systems, including septic tank effluent pump (STEP) systems,
and Attachment II shall be used for vacuum sewer systems (include Attachments I or II with the submittal of this form as applicable). These
checklists cover important items but are not necessarily completely comprehensive of collection system construction and do not relieve the
engineer from designing the collection system following sound engineering practices.
Complete the tables below (or Attachments I or II as applicable) as follows:
x The engineer shall initial each requirement if the project has been designed to comply with the standard or criteria.
x Mark “NA” if the requirement does not apply to this project and provide an explanation in section (5)B.
x Mark “NC” if the project has not been designed to comply with the requirement and provide an explanation in section (5)B, including
any rule references.
Note, if the project has not been designed in accordance with the standards and criteria set forth in Rules 62-604.400(1) and (2), F.A.C., an
application for an individual permit shall be submitted. However, if Rules 62-604.400(1) and (2), F.A.C., specifically allow for another
alternative that will result in an equivalent level of reliability and public health protection, the project can be constructed using the general
permit. Also note that each requirement below and in Attachments I and II includes a reference to guidance or rule for further information.
The guidance documents given in the checklists are as follows:
x “RSWF” – Recommended Standards for Wastewater Facilities (2014). Health Research, Inc., Health Education Services Division, P.O.
Box 7126, Albany, NY 12224, www.healthresearch.org
x “MOPFD-12” – Alternative Sewer Systems, Manual of Practice No. FD-12. Alternative Sewer Systems (1986). Water Environment
Federation, 602 Wythe Street, Alexandria, VA 22314, www.wef.org.
x “FL DSG” – Design and Specification Guidelines for Low Pressure Sewer Systems (1981). Department of Environmental Protection,
2600 Blair Stone Road, MS 3540, Tallahassee, FL 32399-2400, www.floridadep.gov.
x “EPA ACS” - Alternative Wastewater Collection Systems (1991). EPA/625/1-91/024. NTIS# PB93-1162591N2; National Technical
Information Service, 5285 Port Royal Road, Springfield, VA 22161, www.ntis.gov.
General Requirements
Gravity Sewers
Manholes
Stream Crossings
Pump Stations
DEP Form 62-604.300(3)(a), Notification/Application for Constructing a Domestic Wastewater Collection/Transmission Page 9
System Incorporated by reference in subsection 62-604.300(3), F.A.C., (KĐƚŽďĞƌϰ͕ϮϬϮϭ)
DocuSign Envelope ID: 0D4398AD-8955-4347-AA6B-F4523C4F1179
Force Mains
Note, if this project is an alternative collection system (i.e. a low pressure sewer system or a vacuum sewer
system), complete the checklist items on Attachment I for low pressure sewer systems or Attachment II for
vacuum sewer systems. Include the attachment with the submittal. For any items marked “NA” or “NC,” provide
an explanation in section 5(B).
DEP Form 62-604.300(3)(a), Notification/Application for Constructing a Domestic Wastewater Collection/Transmission Page 11
System Incorporated by reference in subsection 62-604.300(3), F.A.C., (KĐƚŽďĞƌϰ͕ϮϬϮϭ)
DocuSign Envelope ID: 0D4398AD-8955-4347-AA6B-F4523C4F1179
B. Explanation for Requirements or Standards Marked “NA” or “NC” in II(5)A above, which includes Attachments I and II (attach additional sheets
if necessary):
DEP Form 62-604.300(3)(a), Notification/Application for Constructing a Domestic Wastewater Collection/Transmission Page 12
System Incorporated by reference in subsection 62-604.300(3), F.A.C., (KĐƚŽďĞƌϰ͕ϮϬϮϭ)
DocuSign Envelope ID: 0D4398AD-8955-4347-AA6B-F4523C4F1179
DocuSign Envelope ID: 0D4398AD-8955-4347-AA6B-F4523C4F1179
DocuSign Envelope ID: 0D4398AD-8955-4347-AA6B-F4523C4F1179
Signed ______________________________________________
1/6/2023
Date _________________________________________________
Name _JODAH B. BITTLE, P.E.
_______________________________________________ 57396
Florida Registration No. __________________________________
SCHULKE, BITTLE & STODDARD, LLC
Company Name ______________________________________________________________________________________________
1717 INDIAN RIVER BOULEVARD, SUITE 201
Address _____________________________________________________________________________________________________
VERO BEACH
City ___________________________________________________ State _FL 32960
____________________ Zip _______________________
772-770-9622
Telephone ___________________________ NA
Cell ____________________________ 772-770-9496
Fax ____________________________________
jbittle@sbsengineers.com
Email ______________________________________________________________________________________________________
100%
Portion of the project for which responsible: _______________________________________________________________________
Signed ______________________________________________
Date _________________________________________________
Name ________________________________________________ Florida Registration No. __________________________________
Company Name ______________________________________________________________________________________________
Address _____________________________________________________________________________________________________
City ___________________________________________________ State _____________________ Zip _______________________
Telephone ___________________________ Cell ____________________________ Fax ____________________________________
Email ______________________________________________________________________________________________________
Portion of the Project for Which Responsible: _______________________________________________________________________
DEP Form 62-604.300(3)(a), Notification/Application for Constructing a Domestic Wastewater Collection/Transmission Page 15
System Incorporated by reference in subsection 62-604.300(3), F.A.C., (KĐƚŽďĞƌϰ͕ϮϬϮϭ)
DocuSign Envelope ID: 0D4398AD-8955-4347-AA6B-F4523C4F1179
Signed ______________________________________________
Date _________________________________________________
Name ________________________________________________ Florida Registration No. __________________________________
Company Name ______________________________________________________________________________________________
Address _____________________________________________________________________________________________________
City ___________________________________________________ State _____________________ Zip _______________________
Telephone ___________________________ Cell ____________________________ Fax ____________________________________
Email ______________________________________________________________________________________________________
Portion of the Project for Which Responsible: _______________________________________________________________________
Signed _________________________
Date __________________________
Name ________________________________________________ Florida Registration No. __________________________________
Company Name ______________________________________________________________________________________________
Address _____________________________________________________________________________________________________
City ___________________________________________________ State _____________________ Zip _______________________
Telephone ___________________________ Cell ____________________________ Fax ____________________________________
Email ______________________________________________________________________________________________________
Portion of the Project for Which Responsible: _______________________________________________________________________
DEP Form 62-604.300(3)(a), Notification/Application for Constructing a Domestic Wastewater Collection/Transmission Page 16
System Incorporated by reference in subsection 62-604.300(3), F.A.C., (KĐƚŽďĞƌϰ͕ϮϬϮϭ)
DocuSign Envelope ID: 0D4398AD-8955-4347-AA6B-F4523C4F1179
General
Appurtenances
Electrical
Emergency Operations
DEP Form 62-604.300(3)(a), Notification/Application for Constructing a Domestic Wastewater Collection/Transmission Page 22
System Incorporated by reference in subsection 62-604.300(3), F.A.C., (KĐƚŽďĞƌϰ͕ϮϬϮϭ)
DocuSign Envelope ID: 0D4398AD-8955-4347-AA6B-F4523C4F1179
General
Vacuum Valves
Valve Pits
Buffer Tanks
Vacuum/Pump Stations
DEP Form 62-604.300(3)(a), Notification/Application for Constructing a Domestic Wastewater Collection/Transmission Page
System Incorporated by reference in subsection 62-604.300(3), F.A.C., (KĐƚŽďĞƌϰ͕ϮϬϮϭ)