HomeMy WebLinkAboutSeptic Approval5L-SC- Z0344,Y/
2740 SW Martin Downs Blvd.#333
Palm City, Florida 34990
Tel. (772) 288 7206
Fax (772) 223 8181
Karner Surveying, Inc.
St. Lucie County Health Department
Re: ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION
2711 S. 19t St., Fort Pierce
Parcel ID: 2421-243-0001-000=3
Crowell
To whom it may concern:
Below please: find the Agent's authorization to submit for an OSTD Permit on
the above referenced property
Please note that I, L u O have authorized KARNER
SURVEYING, INC. on this date _ —` Z to act on my behalf in
matters relative to obtaining an ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM APPLICATION on the above noted property.
Signature Date
For any questions regarding the above referenced permit application please
feel free to contact Kamer Surveying, Inc.
Sincerely,
Regina C. Kamer. PSM
Please e-mail us at karner@comcastnet
c
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Mansueta Crowell
PROPERTY ADDRESS: 2711 S 19th St Fart Pierce, FL 34982
LOT:
PROPERTY ID #:
Z01WIP
SUBDIVISION:
PERMIT #:56SF-2034481
APPLICATION #:AP1464707
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1306106
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
2421-243-0001-000-3 [OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS,
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT TEE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 900 ] GALLONS / GPD Sentic new CAPACITY
A [ ] GALLONS / GPD NIA CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS 01 ]DOSES PER 24 ERS #Pumps [
D [ 375 ] SQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [XI FILLED [ ] MOUND
I CONFIGURATION: [XI TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: Concrete monument near N gate
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D
.O
T
H
E
R
[ 4.00 ]I INCHES FT I [I ABOVE BELOW] BENCHMARK/REFERENCE POINT
[ 4.00 ]I INCHE3 FT ][ABOVE EELOW BENCHMARK/REFERENCE POINT
system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
gpd.
SPECIFICATIONS
BY: Brian J In ram
TIC' Environmental Specialist
II
' APPROVED BY:
TITLE: Environmental Specialist II
St. Lucie CHD
Brian J/ gram
DATE ISSUED:
03/03/20 0
EXPIRATION DATE:
09/03/2021
DH 4016, 08/09
(Obsoletes all previous
editions which may not be used)
Incorporated:
64E-6.003, FAC
Page 1 of 3
v 1.1.4 AP1464707 SE1255518
NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such
proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for
administrative hearing must be in writing and must be received by the Agency Clerk for the
Department, within twenty-one (21) days from the receipt of this order. The address of the
Agency Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency
Clerk's facsimile number is 850-413-8743.
Mediation is not available as an alternative remedy.
Your failure to submit a petition for hearing within 21 days from receipt of this order will
constitute a waiver of your right to an administrative hearing, and this order shall become a'final
order.
Should this order become a final order, a party who is adversely affected by it is entitled
to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are
governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced
by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a
second copy, accompanied by the filing fees required by law, with the Court of Appeal in the
appropriate District Court. The notice must be filed within 30 days of rendition of the final order.
0
01
HEALTH
PAYING ON:
RECEIVED FROM:
PAYMENT FORM:
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
#:56-SF-2034481 6aLDoc #:56-BID-4533809 CONSTRUCTION APPLICATION #: AP1464707
Kamer Surveying Inc AMOUNT PAID: $ 545.00
CHECK 8682 PAYMENT DATE: 01/29/2020
MAIL TO: Mansueta Crowell
FACILITY NAME:
PROPERTY LOCATION:
2711 S 19th St '
Fort Pierce, FL 34982
Lot: Block:
Property ID: 2421-243-0001-000-3
EXPLANATION or DESCRIPTION:
128 - OSTDS Construction System Inspection Research Fee
-1 - Surcharge (All)
-1 - OSTDS New Permit Surcharge
-1 - OSTDS Construction Application and Plan Review,New
123 - OSTDS Construction Site Evaluation
126 - OSTDS Construction Permit (New or Mod, Amendment)
127 - OSTDS Construction System Inspection
133 - OSTDS Construction Reinspection
QUANTITY
FEE
1
$
5.00
1
$
45.00
1
$
100.00
1
$
100.00
1
$
115.00
1
$
55.00
1
$
75.00
1
$
50.00
RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-4274103
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ti ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[� ] New System
[ ] Repair
[ ] Existing System
[ ] Abandonment
PERMIT N0.=SF-o%34481
DATE PAID:
FEE PAID:
RECEIPT #:
[ ] Holding Tank [ ] Innovative
[ ] Temporary [ 7
APPLICANT: Mansueta D. Crowell
AGENT: KARNER SURVEYING INC TELEPHONE(772) 288 7206
MAILING ADDRESS: 27
DOWNS BLVD #333, RA:24 CITY
TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE
CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489.105(3)(m) OR 489.552, FLORIDA STATUTES.
IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE DOCUMENTATION OF THE DATE THE LOT WAS
CREATED OR PLATTED (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER
PROVISIONS.
PROPERTY INFORMATION
LOT: N/A BLOCK: N/A SUBDIVISION: N/1� PLATTED: N/A
PROPERTY ID #: 2421-243-0001-000-3 ZONING: I/M OR EQUIVALENT: [ Y / N ]
PROPERTY SIZE: 1.74 ACRES WATER SUPPLY: [] PRIVATE PUBLIC [1' ]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y / N ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: 2711 S. 19'
DIRECTIONS TO PROPERTY: SEE ATTACHED
BUILDING INFORMATION
Unit Type of
NO Establishment
1
RESIDENCE -Addition
2
ex(sti na houses
3
4
[ ] Floor/Equipment
SIGNATURE:
DH 4015, 10/97
APPLICANT:
AGENT:
[ i] RESIDENTIAL [ ] COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1 Chapter 64E-6, FAC
3 F-�� r
%VC)
ains [ ] Other (Specify)
DATE: 01/ 29/20210
Editions May Be Used) ONLINE VERSION Page 1 of 4
Property owner's full name.
Property owner's legally authorized representative.
STATE OF FLORIDA APPLICATION # AP1464707
DEPARTMENT OF HEALTH PERMIT # 56-SF-2034481
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE1255518
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Mansueta Crowell
CONTRACTOR / AGENT: Kerner Surveying, Inc
LOT: BLOCK:
SUBDIVISION: ID#: 2421-243-0001-000 3
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE
REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: IX]YES- [ ]NO NET USABLE AREA AVAILABLE: 1.74 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 4349.98 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1350.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Concrete monument near N r
ELEVATION OF PROPOSED SYSTEM SITE 4.00 [ INCHES / FT ]
/ BELOW ] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 100 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 61 FT
SITE SUBJECT TO FREQUENT FLOODING?
10 YEAR FLOOD ELEVATION FOR SITE:
£OTT. RRr1FTT.F. TNFr1RMATTON RTTE 1.
[ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO3
FT [ MSL / NGVD ] SITE ELEVATION: ET [ MSL / NGVD
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
I OYR 411
Sand
0 To 20
I OYR 511
Sand
20 To 40
1 OYR 6/1
Sand
32 To 40
1OYR 211
Spodic Material
40 To 46
1OYR 3/3
Fine Sand
46 To 51
1OYR 5/3
Fine Sand
51 To 62
1 OYR 5/3
Loamy Coarse Sand
62 To 72
vn CF11. TI.TFO.R TTAM CTTF. 9
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
10YR 4/2
Fine Sand
0 To 8
10YR 4/1
Fine Sand
8 To 22
1 OYR 511
Fine Sand
22 To 41
10YR 6/1
Sand
41 To 34
1OYR 2/2
Spodic Material
41 To 49
10YR 3/4
Fine Sand
49 To 53
1 OYR 512
Fine Sand
53 To 63
1 OYR 513
Loamy Fine Sand
63 To 72
OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / BELO]] EXISTING GRADE TYPE: [ PERCHED / APPARENT 1
ESTIMATED WET SEASON WATER TABLE ELEVATION: 32 INCHES [ ABOVE / HELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [X]YES [ ]NO MOTTLING: [X]YES [ ]NO DEPTH: 32.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Fine Sand/0.80 DEPTH OF EXCAVATION:
DRAINEIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
r- REMARKS/ADDITIONAL CRITERIA
IT determined using USDA WSS and soil borings.
Mill stripping in 10YR5/1 matrix >10% with diffuse boundaries starting 32" in Sal.
and SB2 4" above SM. it
SITE EVALUATED BY:
Ingram, Brian
Da 4015, 08109 (Obsoletes previous editions v
49 INCHES
DATE: 02/28/2020
e: Environmental Specialist 11) (ENVIRONMENTAL HEALTH)
h may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4
AP1464707 EID2034481 v 1.0.2
0of STATE OF FLORIDA
DEPARTMENT OF HEALTH
` ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
�A �
K�
PERMIT #.
APPLICANT: A7ansueta D. .70W81 AGENT: K F,,'Ns';R SURVEYING !NC
LOT: \; 'i BLOCK: ivi SUBDIVISION: i,]/A
PROPERTY ID #:24217243-0001-000-3 [Section/Township/Parcel No. or Tax ID Number]
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTEMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINNEERS
MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: [q] YES [ ] NO NET USABLE AREA AVAILABLE:0,91 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 _GALLONS PER DAY [RESIDENCES -TABLE 1/OTHER-TABLE21
AUTHORIZED SEWAGE FLOW: 1437 GALLONS PER DAY [1500 GPD/ACRE OR 2500 GPD/ACRE]
UNOBSTRUCTED AREA AVAILABLE: 1350 SQFT UNOBSTRUCTED AREA REQUIRED: 1000 _SQFT
BENCHMARK/REFERENCE POINT. LOCATION: Finished- Floor E1. Of axistinc A.esidance at
ELEVATION OF PROPOSED SYSTEM SITE IS 7.)0 [INCHES/FT] [ABOVE/BELOW] B
POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: :5' _FT DITCHES/SWALES: 15' FT NORMALLY WET? [ ] YES [x] NO .
WELLS: PUBLIC:N/A FT LIMITED USE: FT PRIVATE: 75+ FT NON -POTABLE: 50 FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 10 FT POTABLE WATER LINES: 10 FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [�] NO 10 YEAR FLOODING? [ ] YES [43 NO
10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD
SOIL PROFILE INFORMATION SITE 1
MUNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
`.iU1L Yxuk ll&' 1 vYLx ft'XIU v iA Ixm G
MUNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
_ TO _
TO
USDA SOIL SERIES:
OBSERVED WATER TABLE: INCHES [ABOVE / BELOW] EXISTING GRADE. TYPE:[PERCHED / APPARENT]
ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [ABOVE / BELOW] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO MOTTLING: [ ] YES [ ] NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: INCHES
DRAINFIELD CONFIGURATION: [ ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA:
SITE EVALUATED BY:
DE 4015, 10196 (Replaces HRS-H Fozm 4015 [page 31 wh QA-y be used)
: 01/29/2020
Page 3 of 4
INSTRUCTIONS: