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Get FL Form LEG-R.040.01 2010-2024

St PLEASE FILL OUT ALL APPLICABLE FIELDS Northwest (*Denotes Required Fields Where Applicable) St. Johns River The water well contractor is responsible for completing South Florida this form and forwarding the permit application to the appropriate delegated authority where applicable. Suwannee River DEP Delegated Authority (If Applicable) __________________________ Permit Stipulations Required (See Attached) _ ___________________________________ _ 62-524 Quad No. _______ Delineation No._______.

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