DEP Form 62-730.900(1)(A) "Application for Transfer of a Permit" - Florida

What Is DEP Form 62-730.900(1)(A)?

This is a legal form that was released by the Florida Department of Environmental Protection - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 29, 2006;
  • The latest edition provided by the Florida Department of Environmental Protection;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of DEP Form 62-730.900(1)(A) by clicking the link below or browse more documents and templates provided by the Florida Department of Environmental Protection.

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Download DEP Form 62-730.900(1)(A) "Application for Transfer of a Permit" - Florida

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STATE OF FLORIDA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
APPLICATION FOR TRANSFER OF A PERMIT
Permit No._______________________ Date Issued______________________ Date Expires_____________________
NOTIFICATION OF SALE OR LEGAL TRANSFER
Source Name ________________________________________ County_____________________________________
Source Location______________________________________ City________________________________________
Permittee’s Name_____________________________________ Title_______________________________________
Mailing Address___________________________________________________________________________________
________________________________________________________________________________________________
The undersigned hereby notifies the department of the sale or legal transfer of this pollution source. He further agrees
to assign his rights as permittee to the applicant in the event the department agrees to the transfer of a permit.
Sworn to and subscribed before me at______________ _________________________________________________
County, _______________________ ,
Signature of Permittee
this _____________ day of _______________20____,
_________________________________________________
Title
____________________________________________
Date _________________________________________
Notary Public
My Commission Expires:
________________________________________________________________________________________________
REQUEST FOR TRANSFER OF A PERMIT
Source Name _________________________________________________________________________________
Applicant’s Name _____________________________________ Title____________________________________
Mailing Address_________________________________________________________________________________
________________________________________________ Telephone (____)________________________________
Project Engineer’s Name__________________________________________________________________________
Mailing Address_______________________________________________________________________________
_______________________________________________ Telephone (____)_________________________________
The undersigned hereby notifies the department of his having acquired title to this pollution source. He further states
that he has examined the application and documents submitted by the current permittee, the basis on which Permit
No.___________________ was issued by the department, and states that they accurately and completely describe the
permitted activity or project. He further states that he is familiar with the permit, agrees to comply with its terms and
conditions, and agrees to assume the rights and liabilities contained therein. He also agrees to promptly notify the
department of any future change in ownership of, or responsibility for, the permitted activity or project.
Sworn to and subscribed before me at________________ _______________________________________________
County, ________________________,
Signature of Applicant*
this _______________ day of ______________ 20____ ,
______________________________________________
Title
____________________________________________
Date _________________________________________
Notary Public
My Commission Expires:
*Attach a letter of authorization if the signatory is other than the owner or a corporate officer.
Page 1 of 1
DEP Form 62-730.900(1)(a) effective 1-29-06
STATE OF FLORIDA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
APPLICATION FOR TRANSFER OF A PERMIT
Permit No._______________________ Date Issued______________________ Date Expires_____________________
NOTIFICATION OF SALE OR LEGAL TRANSFER
Source Name ________________________________________ County_____________________________________
Source Location______________________________________ City________________________________________
Permittee’s Name_____________________________________ Title_______________________________________
Mailing Address___________________________________________________________________________________
________________________________________________________________________________________________
The undersigned hereby notifies the department of the sale or legal transfer of this pollution source. He further agrees
to assign his rights as permittee to the applicant in the event the department agrees to the transfer of a permit.
Sworn to and subscribed before me at______________ _________________________________________________
County, _______________________ ,
Signature of Permittee
this _____________ day of _______________20____,
_________________________________________________
Title
____________________________________________
Date _________________________________________
Notary Public
My Commission Expires:
________________________________________________________________________________________________
REQUEST FOR TRANSFER OF A PERMIT
Source Name _________________________________________________________________________________
Applicant’s Name _____________________________________ Title____________________________________
Mailing Address_________________________________________________________________________________
________________________________________________ Telephone (____)________________________________
Project Engineer’s Name__________________________________________________________________________
Mailing Address_______________________________________________________________________________
_______________________________________________ Telephone (____)_________________________________
The undersigned hereby notifies the department of his having acquired title to this pollution source. He further states
that he has examined the application and documents submitted by the current permittee, the basis on which Permit
No.___________________ was issued by the department, and states that they accurately and completely describe the
permitted activity or project. He further states that he is familiar with the permit, agrees to comply with its terms and
conditions, and agrees to assume the rights and liabilities contained therein. He also agrees to promptly notify the
department of any future change in ownership of, or responsibility for, the permitted activity or project.
Sworn to and subscribed before me at________________ _______________________________________________
County, ________________________,
Signature of Applicant*
this _______________ day of ______________ 20____ ,
______________________________________________
Title
____________________________________________
Date _________________________________________
Notary Public
My Commission Expires:
*Attach a letter of authorization if the signatory is other than the owner or a corporate officer.
Page 1 of 1
DEP Form 62-730.900(1)(a) effective 1-29-06