| WATER USE SUBMITTAL REPORT |
| SUBMITTAL INFORMATION | | Application Number | Submittal Number | Submittal Date | | TBD | 204024 | 09/21/2018 |
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| PERMIT TYPE | | Which of the following types of land use/water use classification are your requesting? | Landscape/Recreation | | Which of the following type of activity are you requesting? | Renewal of Existing Permit | | Permit Number: | 11-01580-W |
| Comments & Attached Files | | Comments | Filename & File Size | | |
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| PROJECT LOCATION | | Project Name: | LOWES HOME CENTER - 6415 NAPLES BLVD | | Project Acreage: | 3.05 | | City, Town or Village: | Naples |
| County: COLLIER | | Section(s) | Township | Range | Land Grant | | 11 | 49 | 25 | | | 11 | 49 | 25 | | | Tax Parcel ID(s) | | 66760010015, 66760000012, 66760001752, 66760001820, 66760011027, 66760011221, 66760011289 |
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| LANDSCAPE RECREATION | | Calculated amount of water requested: | Max month allocation <3MGM | Calculated results for daily water usage in
Million Gallons per Day (MGD): | 0.012 | | Does this project use water from multiple surface and/or groundwater sources? | N | What is the duration of this request?
(if >20 years please submit details) | 20 years | | What is the amount of frost/freeze protection requested in Million Gallons per Day (MGD)? | | | What is the type of frost/freeze protection? | |
| Parcel (ID: 44141) | | Parcel Name: | Lowes Home Center-6415 Naples Blvd | | Type of Irrigation System: | Sprinkler | | Number of Acres Irrigated: | 3.05 | | Net Depth of Application (soil type): | 0.4 | | Rainfall Station Name: | TAMIAMI 4 |
| Comments & Attached Files | | Comments | Filename & File Size | | *** Comments Not Applicable *** | |
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| Comments & Attached Files | | Comments | Filename & File Size | | *** Comments Not Applicable *** | |
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| RELEVANT PARTIES | | Select the best representation of the applicant's organization: | PRIVATE |
| Relevant Party (ID: 1919605) | | Type: | AUTHORIZED AGENT | | "Other" Type: | | | First Name: | Jesse | | Last Name: | Shepherd | | Company: | FacilitySource | | Salutation: | | | Address 1: | 6360 METRO PLANTATION ROAD | | Address 2: | | | City: | Columbus | | State: | OH | | Zip: | 33912 | | Primary: | 941-275-1711 | | Secondary: | | | Email: | jshepherd@facilitysource.com | | Date Lease Expires: | | | Is Lease Automatically Renewable? | |
| Relevant Party (ID: 1919606) | | Type: | OWNER/APPLICANT | | "Other" Type: | | | First Name: | Todd | | Last Name: | Sherwood | | Company: | LOWES HOME CENTERS INC | | Salutation: | | | Address 1: | P O BOX 1111 | | Address 2: | | | City: | NORTH WILKESBORO | | State: | NC | | Zip: | 28656 | | Primary: | 336-658-4000 | | Secondary: | | | Email: | todd.r.sherwood@lowes.com | | Date Lease Expires: | | | Is Lease Automatically Renewable? | |
| Comments & Attached Files | | Comments | Filename & File Size | | *** Comments Not Applicable *** | |
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| POTENTIAL WATER IMPACTS | Are there any wetland areas within the area of influence?
If yes, provide an impact evaluation. | No | Are there any contamination sites within the area of influence?
If yes, provide details for the contamination sites. | No | What is the distance to the nearest source of saline water (ft)?
If known, provide a signed/sealed impact assessment. | Unknown |
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| APPLICANT SIGNATURE / OWNER AUTHORIZATION | | Relevant Party Signature Authority | | Type: | OWNER/APPLICANT | | "Other" Type: | | | First Name: | Todd | | Last Name: | Sherwood | | Company: | LOWES HOME CENTERS INC | | Statement Of Agreement | | I hereby certify that the surface water pumps or groundwater wells associated with the water use of this project are located on property I own/lease or that I have the legal right to access, use, and maintain the surface water pumps and groundwater wells. Upon the District's request, I shall provide written documentation demonstrating my legal control of the withdrawal facilities at any time during the application process or the permitted duration.
I certify that to the best of my knowledge and belief that all of the information on this form is correct. I understand that any permit issued shall be subject to review and modification, enforcement action, or revocation, in whole or in part, for any material false statement in an application to continue, initiate, or modify a use, or for any material false statement in any report or statement of fact required of the permittee [Section 373.243(1), Florida Statutes]. With advance notice, I agree to provide District staff with proper identification entry to the project site for the purpose of performing analyses of the site for determining whether the conditions for issuance will be met. Further, if a permit is granted, I agree that, with advance notice, District staff with proper identification shall have permission to enter, inspect, observe, collect samples, and take measurements of permitted facilities to determine compliance with the permit conditions and permitted plans and specifications. | | Prepared by: | | Name: | Jesse Shepherd | | Agency of Employment: | FacilitySource | | Position: | Program Manager | | Email Address: | jshepherd@facilitysource.com | | Phone Number: | 614-318-1700 3405 | | Signature Date: | 09/21/2018 |
| Comments & Attached Files | | Comments | Filename & File Size | | *** Comments Not Applicable *** | |
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| Comments & Attached Files | | Comments | Filename & File Size | | |
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| RELATED PERMITS | | Environmental Resource Permit Status: | The project is existing and unpermitted for Environmental Resource/Surface Water Management. | | Right Of Way Permit Status: | Right Of Way permit is not required. | | Diversion and impoundment Permit Status: | The project has a Diversion and impoundment Permit. | | Permit Number: | 11-01580-w |
| Comments & Attached Files | | Comments | Filename & File Size | | |
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| RECLAIMED WATER | | Is the project using reclaimed water for any of it's water use? | No |
| Comments & Attached Files | | Comments | Filename & File Size | | *** Comments Not Applicable *** | |
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