The URL can be used to link to this page

Home My WebLink AboutHealth Department PERMITSTATE OF FLORIDA APPLICATION # iii"14;5%,;r DEPARTMENT OF HEALTH PERMIT # 56 -SF -08256 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # 5E1298370 SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: Tommy SuOhmeyer CONTRACTOR / AGENT: LOT BLOCK: s UPDI V T s ION : ID # : 4221-2120040-000-4 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 AVAILABL] TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES-TAELEI / AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE 7500.00 GALLONS PER DAY [ 1 1500 GPD/ACRE 4R 1000.00 SQFT UNOBSTRUCTED AREA REQUIRED: , . 5,00 ACRES OTHER -TABLE 2 ] 2500 GPD/ACRE ] 1000.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: Site BM nail set In WPP ELEVATION OF PROPOSED SYSTEM SITE 1.00 [ INCHES / FT 1 [ ABOVE / BELOW I 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: 12 FT PROPERTY LINES: 95 FT POTABLE WATER LINES: 90 FT SITE SUBJECT TO FREQUENT FLOODING? 10 YEAR FLOOD ELEVATION FOR SITE: CnTT. PRnWTT.F. TNTORMATTON ATTR 1 [ ]YES [XINO 10 YEAR FLOODING? [ ]YES [X]NO] FT [ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD USDA SOIL SERIES: Munsell #!Color Texture Depth 1 OYR 4/1 Sand 0 To 8 10YR 5/1 Sand 8 To 36 _ 10YR 613 Sandy Loam 36 To 45 10YR 611 Sand 45 To 50 _ 10YR 712 Sand 50 To 54 7.5YR 518 Sand 54 To 58 10YR 714 Sand 58 To 64 10YR 711 Sand 64 To 70 _ 10YR 613 Sandy Clay Loam 70 To 72 SOIL PROFILE INFORMATION SITE 2 eooTVe, Munsell #/Color Texture depth 10YR 4/1 Sand 0 To S 10YR 511 Sand 8 To 22 10YR 612 Sand 22 To 31 10YR 412 Sand 31 To 40 10YR 613 Sandy Loam 40 To 47 10YR 512 Sand 47 To 52 10YR 714 Sand 52 To 57 7.5YR 518 Sand 57 To 72 OBSERVED WATER TABLE: 0155,00 INCHES [ ABOVE / BELOW I EXISTING GRADE TYPE: ESTIMATED WET SEASON WATER TABLE ELEVATION: 22 INCHES [ ABOVE / BELOW I HIGH WATER TABLE VEGETATION: [ ]YES [X ]NO MOTTLING: [X]YES [ ]NO SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING. DRAINFIELD CONFIGURATION: [X ] TRENCH { r" REMARKS/ADDITIONAL CRITERIA [ PERCHED / APPARENT I EXISTING GRADE DEPTH: 22.00 INCHES 5and/0.80 DEPTH OF EXCAVATION: ] BED [ ] OTHER (SPECIFY) WSWT determined using USDA WSS and soil borings. 10YR 612 stripping in 10YR 511 matrix > 10% with diffuse boundaries starting at 22" in SB2. S82 1" below BVI. S131 0.5" above BM. SITE EVALUATED BY: v Collier, Hunter (Title: Environmental Specialist 1) {Florida Department of Health in St. L DH 4415, 08/89 (Obaoletea previous editians which may not be used) Incorporated: 64E-6.001, FAC AP148'134' EID350,183 47 INCHES DATE: 05/19/2020 Page 3 of 4 '.-1-0-2 a STATE OF FLORIDA DEPAR'T'MENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [✓] New System [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ ] APiI.,=C NT. Tonuny Buckmeyer AGENT: TELEPHONE: MAILING ADDRESS: 20806 Glades Cutoff Rd Port St Lucie, FL 34987 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 (MK/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. PROPERTY INFORMATION LOT_ BLOCK: sU8}72'V"I9ION- PLATTED: PROPERTY ID #: 4221-21.2-0040-000-4 ZONING: I/M OR EQUIVALENT: [ No ] PROPERTY SIZE: 4.99 ACRES WATER SUPPLY: [f] PRIVATE PUBLIC [ ]<=2000GPD [ ]?2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ No I DISTANCE TO SEWER: N/A FT PROPERTY ADDRESS: 20806 Glades Cutoff Rd Port St Lucie, FL 34987 DIRECTIONS TO PROPERTY: FROM THE INTERSECTION OF GLADES CUT OFF ROAD AND MIDWAY ROAD TRAVEL SOUTII WEST FOR 15.8 MILES. THE PROPERTY IS ON THE RIGHT WITH A MOBILE TRAILER IN FRONT. RIGHT AFTER PROPERTY IS A PRIVATE DRIVE TO GET TO PROPOSED IMPROVEMENT AREA. BUILDING INFORMATION [✓] RESIDENTIAL [ I COMMERCIAL Unit Type of No Establishment 1 SINGLE FAMILY 2 3 4 No. of Building Commercial/Institutional System Design Bedrooms Area Sgft Table 1, Chapter 64E-6, FAC 4 2,720 SF [ I Floor/Equipment Drains [ I Other (Specify) SIGNATURE: DATE: ...... ,. _.... _ .._._..N DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC Page 1 of 4 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTQS New APPLICANT: Tommy Buchmeyer PROPERTY ADDRE55: 20806 Glades -Cut -Off Rd Port Saint Lucie, FL 34987 LOT: BLOCK: SUBDIVISION: PERMIT #:56 -SF -08256 APPLICATION #: AP1481347 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT # : PR1349246 OSTDS #: 05-0343-E [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] PROPERTY ID #: 4221-2120040-QQQ-4 [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 [ 1,050 ] GALLONS ( GPD Septic New CAPACITY A [ ] GALLONS / GPD NIA CAPACITY N [ GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 500 ] SQUARE FEET Drainfield New SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [x] MOUND [ ] I CONFIGURATION: (X] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: Site BM nail set in WPP I ELEVATION OF PROPOSED SYSTEM SITE [ 1.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 1.00 ][ INCHES I TT l[ ABOVE BELOW] BENCHMARK/REFERENCE POINT L D E 0 T H E R ILL REQUIRED: [20.00] INCHES EXCAVATION REQUIRED: [ 4t.UUJ INCHES The system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of 400 gpd. SPECIFICATIONS BHunter A Collier TITLE' Environmental Specialist I APPROVED BY: i �'. �'_.�TITIE: Environmental Specialist I Hunter A Collier DATE ISSUED: 05/22/2020 EXPIRATION DATE: DH 4026, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC v 1.14 AP1481347 SE1298370 St, Lucie CHD 11/19/2021 Page 1 of 3 a u�— ,!$es $TATIE Or- FLORIDA PERMIT APPUCATION TO CONSTRUCT, REPA$Et,lttkd DIPY,0RASANDONAWELL permit No. 59-3()57+ 0 Southwest Rofida Unique ID PLBAs' FILL OUTALL APPLICABLE FIELk35 0 Northwest =`17 mates l�egUtrgd F'aide Where AmIicable} Permit Sliputaflons Required (Stir Attached) tit. Jrshna Aver • , `*;; r' ctitll FlOrlda iFrotaQlcr•�rcifcnnuactarlarvspanslbfefofcampiating - .. rhfsFnrtftrutdfortsarrtinp[hepeamirnppL+�rrtn7tPnCha 52-824 Quad No, Det3n9a�URnhie. aOt►1Vs '� I�$uW8nr7�E RIYar apjtrzrprratedrlc�nFrrimeti[ar7[yvrhereapp!(aabfe C DEP Ct1PMl[iP ApDllcailon No. DG:Ogated Authority (If APPI16able 1.70mmy Buchlrleyer 20806 glades Cut Off Road Port St Lucie, FI 34987 "�5C wrcar, Legal N.rneiFCcrparauon ;Address *City ;State *ZIPiefephone Number. 2.20806 Glades Cut Off Road Port St Lucle . FI 34987 . 'Well Location -Address. Road Name or Number, City 3.4221.212-0040-080-4 - 'Parcel ID No, (PIN) or Alternate Key (Circle one) Lot 8iocic Unit Y 4.21 _ 378 38E St Lucle If *Section of Land Grant 'Township 'Range *County Subdivision Check 62424[j Yes ©Nd S, James PaauI lysarl 19352. 934-818-4269 dovinthehole att.net "Water 1rVeli Contractor `UCQnse Number 'Tidephone hiuit bl ar 1 erriall Address 6, PO BOX 881496 Pett St. Lucie FI 34968 'Water Well + Contractor's Address Cfty t 7. *Type of Work: . Construction ® Repair Ej Modiiicatlon[j Abandonment )�DD 8, *Number4f.Proposed Wells 'ReasonfurFtapp� Mcaxicasc arA>Jsnucnracnk S. lSpecify Intended Use(s) of Woii(s}: asta p iiameStiC Landscape Irrigation : [� Agricultural Irr4atlon alto Investigations r n n Bottled Water Supply t Recreation Area Irrigation ❑ r. 2 , JAI(, 9 t lye9toC� Manitciring I Publia Water Supply (Limited Us01DOFf) Nursery Irrigation Test Public Water Supply (Community or Ncri-CommunlWDEP)� C . mercialltndustrial V Earth -Coupled "Geothermal CIas.s I injection Gaff course Irrigation HVAC supply OH in St Lucie Co It'y crass V iefectionl [ Recharge ComrnereralflndustriaE DIs seal q HVAC Return E v'II�E3NMENTAL HEALTH H j p Aquifer Scor a and Rt9c81fery C3 Dralnaae Remedlatlory [j Recovery[] Air Sparge 0 Other twscribat 4iftciat ties Onh1 ® Other lDBscdlwi 10,*Distance from Septic System it 5 2aa ft. 1 i. FsCiifty Dasl riptlan r0 CsC Residence 12, Estimated Slt3r( []ate IVEstln atedWell Depth. 92O ft, -Estimated -Casing Depth 'f 00 n; Prlmaq Casing Diameter 2 : in; Open Hole: from 14. Esltmaled Screen InlarvaG From _100 To _120 ft. 16.*Primary Casing Materlai. Black Steel Galvanized Stainless Steel Not Cooed Other: 16. Secondary Ciaslrrg: Telescope Casing Liner Surface Casing 01arnewr 17. Secondary Ceasing Material: Black Steel Galvanized PVC ewmess Steel Ocher - —. 18'Method of Construction, Repair, orAbandbriment., . Auger Cable Tool Jetted sonic Coml5lnation (Two or More Methods) Hatrd Driven (Well Point, Send PclnO Flydrautic P.otnt (Direct Puoh) Horizontal Diming Plugged by Approved Method Other Iostinrinai 19, Proposed Grouting Interval for the Primary. Sarnndary, and *,at g=. 3, From 0 „ To 95�„ Seat material ( Bentonite�nt Other } From__. . To Seat Material ( Bentonite Cement other - FrottL_ To Seal Material ( sentonito Neat Cement Other 1 Firm _ To seal Matorlal ( Bentorille Neat Cement Other: } 20. InaMcetel total number of eiciatingwells on site i3 List number of existing unused wells an sits 0. . 21Ma-thfs w I .ar any exleiing wrell or water wit �I on the owner's cent uous pproper�e�yr covered under a ConsurnpllveMator Una Permit (CUPANUP) or CUP i� Application-? Y 1 If yes, cornplato the foliowing:CUP UP Na. _ District Well ID No. 22. Latitudes Longitude 23. Data Obtained From: GPS Map Survey. t�atum NAC} 27 p x : alraereWBpMrlr3hthi.czr:uh7Btu§x.Vtkiv�,FtereBWr htiarxCad .eaw;t-„... DatU at_orwun _,,••,NAD$8 WGS84 eFttty, DxlUtr F.rvrnwncn WuYfdtaih Bccurara and [Boll B-wuvtr0 of arga Yllrt�IrnerA09,#u 6ron OtvMnBeLFiIROdprlar id mrnrnl..rrv.eolafw*C rmepxg7a7t� rola Cfiup.or ala, rlaeila StatOlu:To RlBJwin wYrdrrtN lblll4St. [E[:sWetv,Iill.F,'thpl�um nresut-ar.ls.warauY.�yy nkhwu Cut.. µpffaawdrdM M.iC BppticauanHoawtxl0 o-namulvekv .n 1'neldMltfWytOtAvpb.dutlhl 4+Woratlanrwu�elia eu.ts.+B$inttLnVe tarergtidurroo-avof8.ctt - p0WW;a l" ffl1 the arfltoewt30 daIorro.al dF'++ma�@rthpapproact, inlr.atc p.vACe BvnO u7prnkolf•9ty dtOtsledehaw. P..'»nuodnsn"io.GcwtAgooiA ndur9E*IM1tlta Oros dAWw1ty Y"ten mdW>t dntepdek [#e 0i#[dWihh 30d eO4q oeapistionafthp gnsrrazcuO.s•rep.ir,.eednr_tiat.,: thOW00 to dodig jr* weruOssv",FQ .ffi,,U tad.ltaera+lore.Bentsuy„vipW lr ,Ftpairr f,. OS+ndOsvuni�dasliiuuPrgWtfrt&iesutl{Etfd6V9d4d1.SLhl4ltYYiGt.1�++. �raS.- - k 11352 4/2212020 'Slgrietu(s of Cuntreclor r 'Lkense No.-UlgnaWra of-Dvinor orAsonk •pals ApprovalBy tai _ � issue Oat$ "+ ')_'l . } a1. Exptraf on tato t Hydratoatst Apprgval Fee Received RseaipiNn; -- Checkrac. mows OT VALID UNT1L PROPERLY SIGNED BY AN AUTHOROW OFFICER Ori R£PRE SENTATIVE OF THE WMD OR DELEGATED AUTHORrrY. THE E AVAILABLE hTTtit MLL BITE DuRiNG ALL CONSTRUCTION, REPAIR. ktDpiFICATtpN..OR ABAfifl7CittIMENrAGTivi7t�5. - DEP t'a1m:62ar'b2.9ao(t) : lncorparatnd It+ ez-632,4D0(t). F.A.G. EMtao#vp D314: Q¢k4iaor 7.,zalgv Page 9 eC2 a3,r f� 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.