HomeMy WebLinkAboutSewageSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND
SYSTEM
CONSTRUCTION PERMIT FOR:
APPLICANT: Vincent Cimino
OSTDS New
PROPERTY ADDRESS: 6702 Donlon Rd Fort Pierce. FL 34951
PERMIT u:56-SF-2043950
APPLICATION a: AP1470811
MAY G S '020
STLucie County, Permitting
LOT: 6 BLOCK: 134a SUBDIVISION: Lakewood
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1318940
PROPERTY ID jI: 1301-612-0390-000-6 [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
T [ 900 ] GALLONS / GPD SeDtic -new CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ .]DOSES PER 24 HRS #)Pumps [ ]
D [ 375 ] SQUARE FEET
R [ ] SQUARE FEET
A TYPE SYSTEM: [ ]
I CONFIGURATION: [x]
N
F LOCATION OF BENCHMARK:
Drainfield new SYSTEM
NIA SYSTEM
STANDARD [X] FILLED [I MOUND [ ]
TRENCH [ ] BED [ ]
Site BM, paint'Y', CL of Donlon Rd, at Lantana Dr. Elev 21.49
I ELEVATION OF PROPOSED SYSTEM SITE [ 3.00 ][ INCHES FT I ABOVE BELOW] BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 1.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D
0
T
H
E
R
"1LL AWvJ M W; L 14.VVJ 1NUHb:J CXGAVA'11VN RNQU11tSu: J 9D.VV J 1Vunz8
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
300 gpd.
SPECIFICATIONS
r
BY: Brian J In am
TITLE' Environmental Specialist
II
APPROVED BY:
TITLE: Environmental Specialist II
St. Lucie CED
Brian J In am
PLATE ISSUED:
03/19/2020
EXPIRATION DATE:
09/19/2021
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 "1470811 SE1268346
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.
u:•a
HEALTH
PAYING ON:
RECEIVED FROM
PAYMENT FORM:
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
#:56-SF-2043950 BILL DOC#:56-BID-4563355 CONSTRUCTION APPLICATION #: AP1470811
Atlantic Land Desiqns of the TC AMOUNT PAID: $ 660.00
CREDIT CARD 00671P PAYMENT DATE: 03/02/2020
MAIL TO: Vincent Cimino
FACILITY NAME:
PROPERTY LOCATION:
6702 Donlon Rd
Fort Pierce, FL 34951
Lot: Block:
Property ID:
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
-1 - Well Construction
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
1
$
115.00
3 l4? 0 20 — s I l, CaYw�
RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-4302959
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
\)EL1.. t40. 59-30349
PERMIT NO. 5 —ao 950
DATE PAID: 2O D
FEE PAID: 0—
RECEIPT #:
New System [ ] Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair [ ] Abandonment [ ] Temporary [ ].
APPLICANT: Vincent Cimino
AGENT: Atlantic Land Designs of the Tc, Inc. TELEPHONE: 772-398-4290
MAILING ADDRESS: PO Box 1421 Jensen Beach, Florida 34958 Email - ALD5543@Gmail.com
------------------------------------------------------------------------------------------
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: 6 BLOCK: 134A SUBDIVISION: Lakewood Park Unit 10
PLATTED: 1959
PROPERTY ID #: 1301-612-0390-000-6 ZONING: RS-4 I/M OR EQUIVALENT: [ No
PROPERTY SIZE: 0.25 ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [,(]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: N/A FT
PROPERTY ADDRESS: 6702 Donlon Road, Fort Pierce Florida
DIRECTIONS TO PROPERTY: See attached Map
BUILDING INFORMATION
Unit Type of
No Establishment
I Residential
2
3
4
[✓I RESIDENTIAL [ ] COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Soft Table 1, Chapter 64E-6, FAC
3 1 UA
JFP
[ ] Floor/Equipment Drains [ ] Other (Specify)
" SIGNATURE:
DATE: 2/26/20
DH 4015, 08/09 Obsol tes previous editions which may not be used)
Incorporated 64E- 1, FAC Page 1 of 4
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4,. STATE OF FLORIDA
{ '' DEPARTMENT OF HEALTH
p ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
x SITE EVALUATION AND SYSTEM SPECIFICATIONS
PERMIT
APPLICANT: Vincent Cimino AGENT: Altnatic Land Designs of the TC, Inc.
LOT: 6 BLOCK: 134A SUBDIVISION: Lakewood Park Unit 10
PROPERTY ID #: 1301-612-0390-000-6 [Section/I'ownship/Parcel No. or 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: 0.25
ACRES
TOTAL ESTIMATED SEWAGE FLOW:
GALLONS
PER DAY [RESIDENCES -TABLE I/OTHER-TABLE2
]
AUTHORIZED SEWAGE FLOW:
GALLONS
PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE
]
UNOBSTRUCTED AREA AVAILABLE:
SQFT
UNOBSTRUCTED AREA REQUIRED:
SQFT
BENCHMARK/REFERENCE POINT LOCATION: CL asphalt at intersection
ELEVATION OF PROPOSED SYSTEM SITE IS [INCHES/PT ] [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? [ ] YES ]✓] NO
WELLS: PUBLIC: 200 FT LIMITED USE:100 FT PRIVATE: 75 FT NON —POTABLE: 50 FT
BUILDING FOUNDATIONS: 7 FT PROPERTY LINES:I1 FT POTABLE WATER LINES:100 FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES IV] NO 10 YEAR FLOODING? [ ] YES [✓] 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:
USDA SOIL SERIES:
TEXTURE
L'
DEPTH
TO
TO
TO
TO
TO
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:_
DRAINFIELD CONFIGURATION: [ ] TRENCH [ ] BED
REMARKS/ADDITIONAL CRITERIA:
DEPTH OF EXCAVATION: INCHES
[ ] OTHER (SPECIFY)
SITE EVALUATED BY: DATE:
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4