Walton County Planning and Development Services
47 North 6th Street
DeFuniak Springs, Florida 32433
Phone 850-892-8157 * Facsimile 850-892-8162
31 Coastal Centre Boulevard, Suite 100
Santa Rosa Beach, Florida 32459
Phone 850-267-1955 * Facsimile 850-622-9133
NON-REFUNDABLE APPLICATION FEES DUE AT TIME OF SUBMITTAL
AP#________ PMT#____________ ONLY TYPED OR PRINTED APPLICATIONS WILL BE ACCEPTED (NO PENCIL)
Property Information
Tax Parcel Number____-____-_________-_________-___________
Owner’s Name________________________________ E-Mail Address___________________________________
Mailing Address__________________________________ _ Day Phone Number ( ) ________ - _____________
City______________________________ Zip__________________ Fax Number ( ) ________ - _____________
Street Address of Project
_____________________________________________________________________________________________
NUMBER
DIR
STREET NAME
TYPE
SUITE
City___________________________________ County__________________________ Zip___________________
Agent/Contractor (Check one) _____ Agent _____ Contractor (License #______________ ) (if applicable)
Company Name______________________________ Agent/Contractor Name ______________________________
Mailing Address__________________________________ Office Phone Number ( ) __________ - _____________
City______________________ Zip__________________ Mobile Phone Number ( ) __________ - _____________
E-Mail Address for business use _____________________________ Fax Number ( )__________ - _____________
Pond Data: (Check or fill in all that apply)
Pond Type:
Upland Dug Pond: _______
Wetland Dug Pond: ______
Pond Use:
Water Supply: _____
Pond Size:
Length: ______ Avg. Width: ______
Recreational: _____
Embankment Pond: _____
Livestock Watering: ______
Surface Area: _______
Other: ______
Depth: _______
Construction Activity:
When is construction scheduled to begin? _________________________
When is construction scheduled to be complete? ____________________
Farm pond criteria:
� The farm pond must meet the applicable setback requirements of the Walton County Land Development Code.
� The farm pond may not be located within a Walton County jurisdictional wetland or wetland buffer. Pond must be located more than 50
feet from wetlands.
� The farm pond may be no greater than 5 acres in size and have an average depth of less than 15 feet per 11.06.06 of the LDC.
� Any impoundment or dam 10 feet in height or higher (as measured from top of dam to the toe of slope) will require permitting from the
Northwest Florida Water Management District.
� Final location of the pond shall be based on the existing site conditions including soil type and water table. If site conditions are not
appropriate, a farm pond may not be permitted, and any application fees will be forfeited.
The undersigned hereby affirms:
1. I have read and understand the above farm pond criteria.
2. The property Land use is General Agricultural or Large Scale Agricultural and has a valid agricultural exemption from the Walton County
Property Appraiser’s office.
3. Application is hereby made to obtain a permit to do the work and installations as indicated. I verify or affirm that all work will be done in
compliance with all applicable construction, zoning, and environmental regulations.
4. I verify that no work or installation has commenced prior to issuance of this permit. If work has already commenced, I have checked in the
following space. ___________
5. I have the authority to allow and hereby agree to allow County personnel to enter upon this property at any time to inspect development
permitted from this application.
6. I will read and agree to all of the permit conditions.
*** I hereby certify that all information contained in this document is true and correct. ***
__________________________________ Date__________
Owner’s Signature (Required, unless submitted by a licensed building contractor)
STATE OF FLORIDA
COUNTY OF __________________________
Affirmed and subscribed before me this ____day of ________
by ___________________________________________________,
who is personally known to me or who has produced__________
(Type of ID)
______________________ Date____________
Agent/Contractor’s Signature (If applicable)
STATE OF FLORIDA
COUNTY OF__________________________
Affirmed and subscribed before me this _____ day of _______
by ________________________________________________,
who is personally known to me or who has produced____________
(Type of ID)
____________________________________________________________
Signature of Notary Public State of Florida
_________________________________________________________
Signature of Notary Public State of Florida
____________________________________________________________
Print, Type or Stamp Name of Notary
Notarial Seal
_________________________________________________________
Print, Type or Stamp Name of Notary
Notarial Seal
REQUIRED SUBMISSIONS
**These documents shall be legible.**
1. This application and a non-refundable application fee of $100. This non-refundable fee is for the application
review, soils evaluation, water table determination, and final site inspection.
2. Two (2) aerial photos, showing shape and dimensions of parcel, any existing structures, size and location of
proposed pond, location of existing roads, platted rights-of-way, easements, water bodies, watercourses,
wetlands, buffers, street name, property address, and any other information deemed necessary.
STANDARDS AND SPECIFICATIONS
Required Zoning Setbacks:
50’ from public road
50’ from property lines
50’ from any wetland
75’ from any surface water
75’ from septic tank
75’ from well
Once the permit has been issued, it must be displayed on-site for the duration of the work.
The landowner will have twelve (12) months to complete the farm pond construction.
Prior to final inspection all disturbed areas must be stabilized and vegetated to prevent erosion.
Directions to Property (Physical Location)
__________________________________________________________________________________________
___________________________________________________________________________________
Permit Status:
� Approved
� Disapproved
By: ______________________
Title: ________________________
By: ______________________
Title: ________________________
Pemit Conditions:
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________