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Department of Regulatory and Economic Resources Environmental Resources Management MIAMI-DADE 701 NW I st Court, 6th Floor Miami, Florida 33136-3912 T 305-372=6567 F 305-372-6407 miamidade.gov Class V Dewatering Application Form (For operations associated with cleaning and maintenance of stormwater infrastructure and flood protection) For Departmental Use Only Date Received: Application #: Fee Received: $ Tracking #: 1. Checklist: ❑ Application Fee: Dependent upon duration of dewatering permit (all fees include a 7.5% RER surcharge): ❑ 6 days or less $520.00+$39.00 = $559.00* ❑ 7-30 days $635.00+$47.63 = $682.63** ❑ 31-90 days $980.00+$73.50 = $1053.50** ❑ 365 days $2,000.00+$150= $2,150** Note: After -the -Fact Permit applications will be charged a penalty fee amounting to 100% of the original fee, plus departmental administrative enforcement costs. ❑ Attachment A & B (if applicable). * Permit issued for less than 30 days, CANNOT BE EXTENDED, a new permit application will be required. ** Time extension requests have to file at least seven (7) calendar days prior to the time of permit expiration. 2. Project Information: Project Name: This application is for a(n): ❑ New Permit ❑ After the Fact Permit Location: Municipality: Proposed starting date: Estimated completion date: 3. Applicant Information: 4. Applicant's Authorized Permit Agent: This should be the applicant's information for contact purposes. Agent is authorized to process the application, furnish supplemental information relating Name: to the application and bind the applicant to all requirements of the application. Name: Company: Company: Address: Address: Zip Code: Zip Code: Phone #: Fax: Phone #: Fax #: Email: Email: 5. Contractor Information: Name: License # (County/State): Company: Address: Zip Code: Phone #: Fax#: Email: Class V Permit Application Form Page 1 of 7 (Rev 10/24)