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Home My WebLink AboutSewage4,. STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: PERMIT NO. DATE PAID: FEE PAID: RECEIPT #: [v/] New System [ ] Existing System [ ] Holding Tank [ ] Innovative I ] Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT: Robert Vincent Moulton Jr AGENT: AlexanderJ. Piazza PSM, Inc. TELEPHONE: 772-340-7770 MAILING ADDRESS: 619 SW Biltmore Street, Port St. Lucie, Florida 34983 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: 1 BLOCK: PROPERTY ID #: 52 SUBDIVISION: Indian River Estates Unit 7 PLATTED: 1958 3402-608-0441-000-2 ZONING: R I/M OR EQUIVALENT: [ No ] PROPERTY SIZE: 0.333 ACRES WATER SUPPLY. IV(] PRIVATE PUBLIC [ ]<=2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: Bradley Street, Fort Pierce, FL 34982 DIRECTIONS TO PROPERTY: SEE MAP BUILDING Unit Type of No Establishment 1 RESIDENCE E 3 4 [ ] RESIDENTIAL [ ] COMMERCIAL No. of Building Commercial/Institutional System Design Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC 3 1,233 [ ] Floor/Equipment Drains [,/] Other (Specify) GARBAGE GRINDERS/DISPOSALS Oipy.ly uSeN by Akml+l Pi.m Alexander J Piazza ��° ""`m°'" ��° °'° SIGNATURE: ! o:�: po�s.am1]«ate DATE: DH 4015, 08/09 (Obsoletes previous editions which,may not be used) Incorporated 64E-6.001, FAC 9-25-19 Page 1 of 4 9/17/2019 5100 Hickory Dr- Google Maps Goggle Maps 5100 Hickory Dr C, C G F S 0 e H!ckmy ec Nickwy� .. ,. • I ri c ®Palm Lake:Park { 1 _ Scott's Drilling ,. . -" 45100 TT Hickory Drive a+aNcY Sr BraClry 51 aradiry sr ar dtq 5, Bmd:cry Si .{, ® Great Day Enterprises i Burchell Designs` 3 z Boats 8 Motors 4 0 Goggle Map data @2019 200 ft L https://www.geog!e.mm/maps/place/5100+Hickory+Dr,+Fort+Pierce,+FL+34982/@27.3721496,-80.3073364,17z/data=!3m114bl 14m513m4!l sDx88deetbbfa923061:Dxe9d8eebbcbbOed2518m213d27.372... 1/2 6 3o E abed OVH'L009-349 :paJelodloaui (pain aq ;oa .Sem goign suoiyipa enoiAaid s8;aT0sg0) TT/LT 'ST04 Ha 61-5Z-6 :31va :xu aazvnRvna ails ezzeid raapuexaiy aryRaduRrtMmbn (x3I0ads) daHIO S3HONI :NOIMVAVOXa 30 HMdaa SEHONI :HMdaa ON [ I Sax [ ] :ONI'IMMOYa aavdf) VNIMSIXa [ MOIH9/HA09V'1 S3HONI [ .I.NHNVddV /aHHOEIHd ] : adxM • aaVE D 0XISSIX3 G oz oM oz Os oz Os Os Oa oz Hsaaa :s3luas RIOs vases aunzxaM uozoO/# UUHSNnN aaEl Z aiIs N0IMvKa03NI aulaoud RIGS aAox/usx M3 :NOIMVAaRa aiIS aADN/RSH M3 ON Iti Sax [ I L9NIaooR3 wzax oT ON [/A1 :VIualluo RVNOIMIQOV/SHuvwdH [ ] HONHUI [P1 :NOIMVUn5I3NO0 azai3Nlvua :VNIZIS KRISES uOA UMVH f)NIOVOR/a,&=aS BIOS ON [ I Sax [ I :NOIMVIaVaA 3RSVM 'dHSVM H`JIH :NOISVAH'Ia 3RHVM E43MVM NOSV3S SUM allIVNIISE MOTHS1 SHHONI +Ot:3RHVM UUMVM aaATIaSSO :Saxuas UIOS Vasa oz oz OM Os oz OS Oz oM oz Hzd3a amixaz 'dOROO/# RRaSNnR C 3MIS NOIIIvm03NI aRI3oud BIOS :aiiIs wa NOIMVAzaa a00R3 uvax OT Sax [ 1 :oNiaooria MNanbaua oM zoarHns ails za :SzNIR dazvK azavzoa la 01:saNIR XMuadoud za S:sNOIMvaNII03 9NIcrims za 001 : TIEVIOa-NON Md SL : RMVAIua la 001 :3Sn aaimiR za OOZ :OiRena : SRRaM ON [/] Sax I 1 LMaM XrITV ON 13 SI :SHRVMs/SRHOzxa Ma 001 :uazvM aOvauns S3unMVU3 VNIMORROd SHM OS KZISES aHSOdOdd allM HOud a3NIVMNIVK HE NV0 HOIHM HOVSM3S XOkUNINi aHM MNIOd aDXHH333H/XHVM0N39 [.MO"I29/9AOHV] [ .I3/SEHON11 t£SI ails DsisxS azsoaouci 30 NOIMVA3'Ia :NOIMVOo'I MNIOa aoxaua3au/HUIsuIONaS Maas 09L :aauxnbau vauv mionuzssoNn Ia5s 09L :3RHVRIVAV VauV aaI3nuMs9ONn [ allDV/Qd0009Z'dOHHDV/Qd'J00911 LVa Had SNO'IMM :MOR3 mmmaS aazzdoHMRV [ Z H'IfiV.L-,danLO/[ H•IHV,L-SHONHQISa-�I I xva uaa SNORRVJ 009 :Mo73 a9VMas aazVPIIMs3 RVMOM SaHOV £££'O :ZURVRIVAV VHUV aRflVSn MaN ON [ ] Sax V :NVRa aiIS OM SXd03N00 aZls xidadoud •smmi RRV aM37amo •RVMMIaams 30 aovd HOva Ryas aav NOIs aNv dzEMmN NOIMvuMSIOax aaImud MsnN suaamima •NOSHad aUI3IRVno uaHMO u0'aaxORaada makuuwaa HM7V3H 'usaNIma xH aaSaRamo as OM [ aagwnK QI xey I Z-000-I tt0-809-ZOt£ : # ax xMuadoud L I[ufl Salelsg JOAT ue1.pu1 :Noxsxnxams ZS :HDOUH [ :Mori •ouI WSJ eZZUid'f iapuexald : MNaov if uollnoW luaau[A liago-d : MNVOIRddv smii oiai 3as D aisxS auv xoizvnrIVAa 3SIS Nazsxs 'Ifdsoasia amv zmuva Tz aromas amisxo HzzMH ao zxwzuadsa # MlHauaa VCEIuoga ao alIVIS APPLICANT'S NAME: Robert Vincent Moulton Jr LEGAL DESCRIPTION: Lot 1, Block 52 of Indian River Estates Unit 7, PB 10, PG 75. I certify that there are no potable private wells within 75 feet of the available area for the proposed septic system, that there are no non -potable wells within 50 feet of the available area for the proposed septic system, that there are no wells within 25 feet of a pesticide -treated building foundation, that there are no public wells that serve less than 25 people or less than 15 homes or businesses within 100 feet of the proposed septic system, that there are no public wells that serve more than 25 people or more than 15 homes or businesses within 200 feet of the proposed septic system, that the water line from the water meter or well to the structure is at least 10 feet from the available area for the proposed septic system unless the plans show the line to be double sleeved, that there is not a gravity sewer line, low pressure sewer line or vacuum sewage line in a public easement or right-of-way that abuts the property, that there are no lakes, streams, wetlands, or surface water within 75 feet of the available area for the proposed septic system unless the property was created prior to 1972, that the septic system is proposed on the side of the lot farthest from surface water, that all private wells, septic systems and surface water on adjacent or contiguous land within 75 feet of the applicant's lot are shown on the site plan, that all public wells within 200 feet of the applicant's lot are shown on the site plan, and that the location of building or residences, swimming pools, recorded easements, paved areas or driveways, sidewalks, the general slope of the property, filled areas, drainage features, and surface waters such as lakes, ponds, streams, canals, or wetlands are shown on the applicants lot. The natural grade elevation in the area of theproposed septic system and the benchmark must be shown on the site plan. Please locate the benchmark within 200 feet of the proposed septic system. NOTE: MUST BE CERTIFIED BY A FLORIDA REGISTERED SURVEYOR OR ENGINEER. Alexander l5iazza�Z" CERTIFIED BY: _�ssnra m FLORIDA PROFESSIONAL NO.:' 6330 DATE: 09/25/19 JOB NO.: 19-4842 docstforms/septics/SepticApppPage207 I STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM PERMIT CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Rnhert Mrndfnn PROPERTY ADDRESS: TBD Bradley St Fort Pierce, FL 34982 LOT: 1 BLOCK: 52 SUBDIVISION: PROPERTY ID #: 3402-608-0441-000-2 PERMIT #: 56-SF-2012886 APPLICATION #: AP1450993 DATE PAID: FEE PAID: RECEIPT #• DOCUMENT #: PR1284252 Indian River Estates [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [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 THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ 900 ] GALLONS / GPD SeDtic New CAPACITY A [ ] GALLONS / GPD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:I250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 RRS #Pumps [ ] D [ 375 ] SQUARE FEET Drainfield New SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [X] FILLED [] MOUND I CONFIGURATION: [XI TRENCH [ ] BED [ 1 N F LOCATION OF BENCHMARK: Site BM Painted "X" in C/R Hickory Dr I ELEVATION OF PROPOSED SYSTEM SITE [ 7.00 ][ INCHES FT ][ABOVE E BOTTOM OF DRAINFIELD TO BE [ 8.00 ] [ INCHES FT ] [ ABOVE L D FILL REQUIRED: 117.00] INCHES EXCAVATION REQUIRED: [ 0 T H E R BENCHMARK/REFERENCE POINT BENCHMARK/REFERENCE POINT ] INCHES 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: Dianna S May TITLE: Environmental Supervisor I APPROVED BY: � "�' TITLE: Environmental Supervisor I St. Lucie CHD Dianna S Ma0 DATE ISSUED: 12/10/2019 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC EXPIRATION DATE: 06/10/2021 Page 1 of 3 A 1450993 SE1233094 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. PAYING ON: RECEIVED FROM PAYMENT FORM: St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 u:56-SF-2012886 BILL Docy.56-BID-4479949 CONSTRUCTION APPLICATION #.AP1450993 Alexander J. Piazza PSM, Inc John Erick AMOUNT PAID: $ 545.00 CHECK 4879 PAYMENT DATE: 10/31/2019 MAIL TO: Robert Moulton FACILITY NAME: PROPERTY LOCATION: TBD Bradley St Fort Pierce, FL 34982 Lot: Block: 52 Property ID: 3402-608-0441-000-2 EXPLANATION or DESCRIPTION: QUANTITY FEE 128 - OSTDS Construction System Inspection Research Fee 1 $ 5.00 -1 - Surcharge (All) 1 $ 45.00 -1 - OSTDS New Permit Surcharge 1 $ 100.00 -1 - OSTDS Construction Application and Plan Review,New 1 $ 100.00 123 - OSTDS Construction Site Evaluation 1 $ 115.00 126 - OSTDS Construction Permit (New or Mod, Amendment) 1 $ 55.00 127 - OSTDS Construction System Inspection 1 $ 75.00 133 - OSTDS Construction Reinspection 1 $ 50.00 RECEIVED BY: MontanezNM AUDIT CONTROL NO. 55-PID-4222575 ��'% 1 ' �j11E yam` STATE OF FLORIDA r DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [1/] New System [ ] Existing System [ ] Holding Tank [ ] Repair [ ] Abandonment ( ] Temporary APPLICANT: Robert Vincent Moulton Jr AGENT: MAILING ADDRESS: PERMIT NO.5k-:SF-oDj9tU'aI.P DATE PAID: FEE PAID: 45 RECEIPT #: a* [ ] Innovative [ l Alexander J. Piazza PSM, Inc. TELEPHONE: 772-340-7770 619 SW Biltmore Street, Port St. Lucie, Florida 34983 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 APPLICANTS 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: I BLOCK: 52 SUBDIVISION: Indian River Estates Unit 7 PLATTED: 1958 PROPERTY ID #: 3402-608-0441-000-2 ZONING: R I/M OR EQUIVALENT: [ No I PROPERTY SIZE: 93 ACRES WATER SUPPLY: [1/] PRIVATE PUBLIC [ ]<=2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: Bradley Street, Fort Pierce, FL 34982 DIRECTIONS TO PROPERTY: SEE MAP BUILDING INFORMATION Unit Type of No Establishment 1 RESIDENCE 2 3 4 [ ] Floor/Equipment Drains Iv( Other (Specify) GARBAGE GRINDERS/DISPOSALS �] oNn.ba�M�wa.lnv.. SIGNATURE: Alexander J Piazza n'�a amp•mxoownsertucvmowivxi..nnm..e+1 DATE: 9-25-19 [,(I RESIDENTIAL [ ] COMMERCIAL No, of Building Commercial/Institutional System Design Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC 3 1,233 DH'4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC Page 1 of 4 STATE OF FLORIDA APPLICATION # AP1450993 DEPARTMENT OF HEALTH PERMIT # 56-SF-2012886 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1233094 APPLICANT: Robert Moulton CONTRACTOR / AGENT: Alexander J. Piazza PSM, Inc John Erickson 772-260-5049 -LOT: 1 13LOCK: 52 SUBDIVISION: Indian River Estates ID#: 3402-608-0441-000-2 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: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 0,34 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 509.99 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 750.00 SQFT UNOBSTRUCTED AREA REQUIRED: 563.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: Site ELEVATION OF PROPOSED SYSTEM SITE 7.fin FP I [ ABOVE /IBELOWI] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES/SWALES: 14 FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 14 FT POTABLE WATER LINES: 30 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES IX]NO 10 YEAR FLOODING? [ ]YES [X]NOI 10 YEAR FLOOD ELEVATION FOR SITE: FT [ MSL / NGVD I SITE ELEVATION: FT [ MSL / NGVD SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES:Waveland fine sand Munsell #/Color Texture Depth 1OYR 511 Sand 0 To 13 10YR 411 Sand 13 To 16 10YR 511 Sand 16 To 30 10YR 6/1 Sand 25 To 44 1 OYR 3/1 Specie Material 44 To 56 10YR 3/2 Sandy Loam 56 To 64 10YR 413 Sandy Loam 64 To 72 USDA SOIL SERIES:WavelaIld fine Sand Munseli #/Color Texture Depth 1 OYR 5/1 Sand 0 To 15 10YR 411 Sand 15 To 21 10YR 5/2 Sand 21 To 38 10YR 6/1 Sand 28 To 48 1 OYR 3/1 Spodic Material 48 To 56 1 OYR 3/2 Sandy Loam 56 To 62 10YR 4/3 Sandy Loam 62 To 72 OBSERVED WATER TABLE: 44.00 INCHES [ ABOVE / BELOW]] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 25 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 25.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY) [- REMARKS/ADDITIONAL CRITERIA VT determined using USDA WSS and soil borings. 10YR6/1 stripping >10% with diffused boundaries starting at 25" in SB1. and SB2 T' below BM. mental SITE EVALUATED BY:�� DATE: May, Dianna (Title: Envlro Supervisor 1) (Florida Department of Health in St Lu DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC INCHES 12/05/2019 Page 3 of 4 AP1450993 EID2012886 v 1.0.2 APPLICANT'S NAME: Robert Vincent Moulton Jr LEGAL DESCRIPTION: Lot 1, Block 52 of Indian Riuer Estates Unit 7, PB 10, PG 75. PROPOSED SEPH0--:A9TE1iT=1NF0R1tifA7W . I certify that there are no potable private wells within 75 feet of the available area for the proposed septic system, that there are no non -potable wells within 50 feet of the available area for the proposed septic system,. that there are no wells within 25 feet of a pesticide -treated building foundation, that there are no public wells that serve less than 25 people or less than 15 homes or businesses within 100 feet of the proposed septic system, that there are no public wells that serve more than 25 people or more than 15 homes or businesses within 200 feet of the proposed septic system, that the water line from the water meter or well to the structure is at least 10 feet from the available area for the proposed septic system unless the plans show the fine to be double sleeved, that there is not a gravity sewer line, low pressure sewer line or vacuum sewage line in a public easement or right-of-way that abuts the property, that there are no lakes, streams, wetlands, or surface water within 75 feet of the available. area for the proposed septic system unless the property was created prior to 1972, that the septic system is proposed on the side of the lot farthest from surface water, that all private wells, septic systems and surface water on adjacent or contiguous land within 75 feet of the applicant's lot are shown on the site plan, that all public wells within 200 feet of the applicant's lot are shown on the site plan, and that the location of building or residences, swimming pools, recorded easements, paved areas or driveways, sidewalks, the general slope of the property, filled areas, drainage features, and surface waters such as lakes, ponds, streams, canals, or wetlands are shown on the applicants lot. The natural grade elevation in the area of the. proposed septic system and the benchmark must be shown on the site plan. Please locate the benchmark within 200 feet of the proposed septic system. ' NOTE: MUST BE CERTIFIED BY A FLORIDA REGISTERED SURVEYOR OR ENGINEER. omau>su�menm Alexander J Piazza a n'�'��'m'• CERTIFIED BY: FLORIDA PROFESSIONAL NO.: 6330 DATE: 09/25/19 JOB NO.: 19-4842 docs/ro ms/septics/SepdcApppPage207 St. Lucie County Building and Zoning Department Requirements for 30 Day Power for Testing I. Form entitled "Request for 30-Day Temporary Power Release" must be fully executed and posted in the Building Department record files prior to inspection. II. Inspection Requirements: 1. Address numbers shall be posted per county Ord. No. 7.05.09. 2. All entrances, exits, windows and garage doors must be lockable. 3. All circuits on exterior shall be terminated in a box with weatherproof cover. The same applies to a disconnect. If circuits are at or above 7'6" from grade they may be capped with wire nuts and taped. 4. All breakers must be installed. Any blank space must be closed by a breaker or approved filler plates. 5. Interior Wiring: All receptacles, light fixtures and fans must be trimmed. Any fixture below 7'6" from the floor or mezzanine that is not available at the time of inspection must have an Inviso plate installed. Fixtures at or above that height may be capped with wire nuts and taped. 6. All smoke detectors must be installed. 7. Kitchen cabinets must be installed; any exception for special conditions or circumstances must have an approval prior to scheduled inspection. 8. Sewer and water connections must be complete. Only well pumps are excluded from this requirement. 9. Exterior construction must be complete and weather tight, including stucco, siding, roof and soffit. 10. Permit work shall be substantially completed except for back orders, paint on exterior, carpet and/or floor covering, pumps, air conditioners and driveway. APPLICANT: STATE OF FLORIDA, DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS Robert Vincent Moulton Jr PERMIT #. Alexander J. Piazza PSM, Inc. LOT: 1 BLOCK: 52 SUBDIVISION: Indian River Estates Unit? PROPERTY ID #: 3402-'608-0441-000-2 [Tax ID Number ] 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: [✓] YES [ ] NO NET USABLE AREA AVAILABLE: 0.333 ACRES TOTAL ESTIMATED SEWAGE FLOW: 500 GALLONS PER DAY [ RESIDENCES -TABLE T/OTHER-TA13LE2 ] AUTHORIZED SEWAGE FLOW: GALLONS PER DAY [1500GPD/ACRE OR2500GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 750 SQFT UNOBSTRUCTED AREA REQUIRED: 750 SQFT BENCHMARK/REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE IS34 [INCHES/FT J [ABOVE/BELOW'] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER:100 FT DITCHES/SWALES:15 FT NORMALLY WET? [ I YES I✓] NO WELLS: PUBLIC: 200 FT LIMITED USE: 100 FT PRIVATE: 75 FT NON —POTABLE: ]00 FT BUILDING FOUNDATIONS:5 FT PROPERTY LINES: 10 FT POTABLE WATER LINES: FT SITE SUBJECT TO FREQUENT FLOODING: I ] YES [✓] NO 10 YEAR FLOODING? [ ] YES I✓] 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: SOIL PROFILE INFORMATION SITE 2 MUNSELL #/COLOR TEXTURE DEPTH TO TO TO TO TO TO TO TO TO USDA SOIL SERIES: OBSERVED WATER TABLE:40+ INCHES [BELOW 1] EXISTING GRADE. TYPE: (PERCHED/ APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [.ABOVE/BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ I YES [ ] NO MOTTLING: [ ] YES [ I NO DEPTH: INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [✓] TRENCH [ J BED [ ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA: Y a Y.Hn Y Alexander J Piazza MO,.m na llalM +P01a91i[WW I6581 EEIC W019B I.mGI¢aantlm rza SITE EVALUATED BY: wl.aol9.oalsllnaesumDATE: 9-25-19 0H 4015, 12/11 (obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4