HomeMy WebLinkAboutSewageSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Wade Jurney Homes, LLC
CONTRACTOR / AGENT: Wade JUrney Homes LLC
LOT: 7 BLOCK: 138
SUBDIVISION: Lakewood Park ID#:1301-613-0042-000-5
19 lb - eking
APPLICATION # AP1413882
PERMIT # 56-SF-1948934
DOCUMENT # SE1178488
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: .0.27 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES -TABLE/ / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 404.00 GALLONS PER DAY [ 1500 GPD/ACRE, OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 2000.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Site BM2 NID In Rd S property line extended E
ELEVATION OF PROPOSED SYSTEM SITE 2.00 [ INCHES / FT ] [ ABOVE / 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: 80 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 65 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO]
10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
ROTT. PROFTT.F. TNFORMATTON RTTF. T ROTT. PROFTT.E TNFORMATTON SITE 2
USDA SOIL SERIES:Lawnwood sand
Munsell #/Color Texture
Depth
10YR 5/1
Sand
0 To 9
1 OYR 611
Sand
9 To 34
tOYR 7/1
Sand
25 To 34
10YR 5/2
Sand
34 To 43
10YR 211
Spodic Material
43 To 63
1 OYR 314
Sand
63 To 72.
USDA SOIL SERIES:Lawnwood sand
Munsell #/Color Texture
Depth
10YR 5/1
Sand
0 To 10
10YR 611
Sand
10 To 36
1 OYR 7/1
Sand
27 To 38
10YR 511
Sand
38 To 45
1OYR 2/1
Spodio Material
45 To 61
10YR 313
Fine Sand
61 To 72
OBSERVED WATER TABLE: 72.00
INCHES [ ABOVE /
EEI
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)
f REMARKS/ADDITIONAL CRITERIA
/SWT determined using USDA WSS and soil borings.
OYR7/1 stripping In 10YR611 matrix, >10% with diffuse boundaries, starting at 26" In SB1
SITE EVALUATED BY:
IngraBian (Tile: ironmental Speciallstil) (ENVIRONMENTAL HEALTH)
DH 4015, 08109 (Obsolates previous editions which Y not be used) Incorporated: 64E-6.001, FAC
AP1413882 EID1948934
INCHES
DATE: 05/20/2019
Page 3 of 4
v 1.0.2
%3r Ol a
0p,e .
" o� STATE OF FLORIDA
i' . DEPARTMENT OF HEALTH
�a ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
"`°"""`� APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[ ] New System [ ] Existing System
[ ] Repair [ ] Abandonment
c.�l"( sg-Z�swe
PERMIT NO.S(0-sr- .0Ug-y3 y
DATE PAID:
FEE PAID: 30 i— U
RECEIPT #: C 1 I
[ ] Holding Tank [ ] Innovative
[ ] Temporary [ ]
APPLICANT: kj,-, S �-k (_l C'
AGEN A 0 X �� l\I�C�,{-"tS�`�,C,�I C' TELEPHONE:
MAILING ADDRESS: Qc
TO BE COMPLETED BY APPLICANT OR APPLICANTtS AUTHORIZED AGENT. SYST$MS 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: 1 BLOCK: k�F3 SUBDIVISION: LVl� C-' PLATTED:
PROPERTY ID #: `,�O `-- (o�- 5- OCj(a-(xri-' ZONING: 5 F-C� I/M OR EQUIVALENT: [ Y / N ]
PROPERTY SIZE:_ ACRES WATER SUPPLY: [ PRIVATE PUBLIC [ .]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y / N ] DISTANCE TO SEWER:
PROPERTY ADDRESS:
DIRECTIONS TO PROPERTY:
BUILDING INFORMATION [ ] RESIDENTIAL [ ] COMMERCIAL
Unit Type of No. of Building Commercial/Institutional System Design
No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
1
/goo SA�c
2
3
4
[ ] Floor/Equipment Drains' [ ] Other (Specify)
t
DATE: I l `-S �. \9�
DH 4015, OS/09 (Obsol'etes previous,-4ditions which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
PAYING ON: a:56-SF-1948934 BILL DOCA:56-BID-4185906 CONSTRUCTION APPLICATION N:AP7413882
RECEIVED FROM: Wade Jurney Homes, LLC AMOUNT PAID: $ 516.00
PAYMENT FORM: CHECK 31774 PAYMENT DATE: 05/13/2019
MAIL TO: (Wade Jurney Homes, LLC)
FACILITY NAME:
PROPERTY LOCATION:
TBD Eastwood or
Fort Pierce, FL 34951
Lot: 7 Black: 138
Property ID: 1301-613-0042-000-5
EXPLANATION or DESCRIPTION: QUANTITY FEE
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 $ 5.00
1 $ 15.00
1 $ 100.00
1 $ 100.00
1 $ 115.00
1 $ 55.00
1 $ 75.00
1 $ 50.00
RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-3940076
Note: Well 59-29548 $630.
nssr STATE OF FLORIDA PERMITAPPLICATION TO CONSTRUCT,
'REPAIR, MODIFY, OR ABANDON A WELL
❑SOUIhWeef PLEASE FILL OUT ALL APPLICABLE FIELDS
❑ Northwest ,('Denotes Required Fields Where Applicable)ona
Johns', River
�oulh Floridaddlformendlanvoid4glheyermilapPGmdonrotlx'
River-
❑ DEP
59-2g548 I
orid.lD -
Required face Attached)❑
L
d. Dellneadan No. _❑Suwannee
ication No.❑
Delegated.Authodly (If Applicable)
1, WJH LLC 3300 Battleground AVE Ste 230 Greensboro, NU 4/41 U r IZ- 0,0w I' `a
`Owner, Legal Name if Corporation - 'Address 'City 'Stale 'ZIP Telephone Number
2. Eastwood Dr. Fort Piere FL 34951
'WellLocallon - Address, RoadWame or Plumber, City
3.1301.613-1J0421-000-5 7 138 11.
-Parcel ID No. (PIN) or Alternate Key (Circle One) Lot Block Unit
4.12 34S 39E St Lucie- Lakewood Park Check If62.524:❑ Yes.[] No
*Section Orland Grant "Township 'Range -County _ Subdivision
S. Scott's Drilling, Inc. 11213 772j189-6117.. scottsdrilling@bellsouth.net
'Water Well Contractor 'License Number 'Telephone Number E-mail Address
G. 5014 Palm Drive Fort Pierce FL. 34962
'WaterWell Contractor's Address - City Stale ZIP
7. 'Type of Wark: ❑✓ Construction ❑ Repair ❑ Modification[] Abandonment _
8. 'Number of Proposed Wells One
9. -Specify Intended Use(s) of Well(s):
y Domestic Landscape irrigation.
a
Bellied Water Supply B,Recreation Areadnigation
] Public Water Supply (Limited Use/DOH)
Public WalerSupply (Community or Non-CommunitylDEP)®
❑
] Class I Injection
Agricultural Irrigation Site Investigations
Livestock H Monitoring
Nureery.lnigalion
Test
Commerdal/Industrial,
Earth -Coupled Geothermal
Golf Course Irrigation.
HVAC Supply
HVAC Relum
V Injection: ❑ Recharge ❑ Commercialdnduslrlal Disposal ❑ Aquifer Storage and Recovery ❑ Drainafq
diation:❑ Recovery❑ Air Sparge ❑ Other lousolba) PM'
ether (Doof-) _
from
If.
5 2019
In St Lurie
13 Eslimated Well Depth 120 ft. !Estimated Casing Depth 100 ft. Primary Casing Diameter 2 in. Open Hole: From —TO _fl.
14.•EstImated Screen Interval: Fram 100 To 120 g,
15.'Pdmary Casing Material: Black Steel Galvanized ✓ PV Stainless Steel
Not Cased Other:
16, Secondary Casing: TelescopeCasing Liner .Surface Casing Diameter In.
17, Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel Other
18.'Melhod ofConstruction, Repair, or Abandonment: Auger Cable Tool Jelled ✓Rotary Sonic
Combination (Two or More Methods) Hand Driven (Well Paint, Sand Point) Hy u Ic olnt(Direct Push) .
Horizontal Drilling Plugged by Approved Method -. Other.Loesodoel
19, Proposed Grouting Interval for the Primary, Secondary, and Additional Casing:
From u To 100 Seal Material( Bentonite Neat Cement Olhcr, )
From_ To Seal Material ( Bentonite Neal Cement Other - 1
From_ To Seal Material( Bentonite Neal Cement Other 1
From_ To Seal Material( Bentonite Neal Cement Other 1
20. Indicate total number of existing wells an site - List number or existing unused wells ensile _
21.'Is this well or any exis0ngg well or welenvilhdm - he owner's contiguous properlyy covered under a ConsumptivefWaler Use Permit(CUPM/UP)
or CUPNYUP Application? _ Yes �yles, complete the following: ClJPM1UPNo, District Well ID No:
22. Latitude Lon
23. Data Obtained From: GPS Map Survey Datum: _NAD 27 _NAD 83. _ WGS 64
eenUmne'M1:uOOYVJyWbpein4 u NV Iv"ul nyLSOw'..AItl•awruvw, Ne4 /
11213 �� c
-Signature of Contactor 'License No. •Signature wnercr Aq It 'Date
Approval Granted By Issue Dale f Expiration Dale 12 ydrdogisl Approval
Kiel,
Fee Received S Receipt No. Check No. .
THIS PERMIT IS NOT VALID UNTIL PROPERLY IGNED BY AN AUTHORIZED OFFICER OR REPRESENTATIVE OF.THE WMD OR DELEGATED AUTHORITY. THE
PERMIT SHALL BE AVAILABLE AT THE WELL SITE DURING ALL CONSTRUCTION, REPAIR, MODIFICATION, OR ASANDONMENTAC T IVITIES.
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.
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: (Wade Jumey Homes, LLC)
PROPERTY ADDRESS: TBD Eastwood Dr Fart Pierce. FL 34951
LOT: 7 BLOCK: 138
SUBDIVISION: Lakewood Park
PERMIT #:56-SF-1948934
APPLICATION #: AP1413882
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1229233
PROPERTY ID #: 1301-613-0042-000-5 [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 [ 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 [x] FILLED [] MOUND [ ]
,,I CONFIGURATION: [X] TRENCH
N
F LOCATION OF BENCHMARK: Site BM2,
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
a
O
T
H
E
R
[ ] BED
NiD in Rd, S property line extended E
[ 2.00 )[ INCHES FT ][ABOVE BELOW P BENCHMARK/REFERENCE POINT
[ 3.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
RGQulR u: J-I r.UUJ INCHES EXCAVATION REQUIRED: t J 1NUHE5
system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated Flow of
gpd.
SPECIFICATIONS
BY: rian J Ingr
TITLE: Environmental Specialist
II
APPROVED BY:
TITLE: Environmental Specialist II
St Lucie CHU
Brian J In
DATE ISSUED:
06/05/2019
EXPIRATION DATE:
12/05/2020
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
AP1413882 SE1178488
Ulm ve,ld�,
STATE OF FLORIDA
DEPARTMENT OF HEALTH
g ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION.FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[ ] New System [ ] Existing System
[ ] Repair [ ] Abandonment
APPLICANT:
M1,1..F 5.25" P
PERMIT NO. S'` 1 �'s[L.WV
DATE PAID:
FEE PAID: 10 D0p
RECEIPT (): CK 31.1-714
[ ] Holding Tank [ ] Innovative
[ ] Temporary [ ]
- / r
TELEPHONE: 1��--��. �-RJ
MAILING ADDRESS: - s; - \.• Od\
1 �•
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 1`,I
LOT: _ BLOCK: t3S SUBDIVISION: L(.��Q L—QC)-A �YJIATTED:
PROPERTY ID N: L 3O� —Iro(,?I -L Cl��- JZONING: I/M OR EQUIVALENT: [ Y / N ]
PROPERTY SIZE: , ACRES WATER SUPPLY: [ X] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [`Y`/ N ] DISTANCE TO SEWER: -S7_FT
PROPERTY ADDRESS:
DIRECTIONS TO PROPERTY:
t
BUILDING INFORMATION [] RESIDENTIAL [ ] COMMERCIAL
Unit Type of
No Establishment
1 Z5 V��
2
3
4
No. of Building Commercial/Institutional System Design
Bedrooms Area S.q£t Table 1, Chapter 64E-6, FAC
M
[ ] Floor/Equipment Drains [ ] Other (Specify)
DH 4015, 08/09 (Obsoletes previous edftibns which may not be used)
Incorporated 64E-6.001, FAC
DATE: oZ
Page 1 of 4
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 hearjng�4arid;�this order shall become a 'final
order'.
Should this order become a
affected by it is entitled
to judicial review pursuant to Section 120e§a�aFIdlida Statujes;.`:Re view proceedings are
governed by the Florida Rules of Appellat QRiocddlure ; SLch proceedings may be commenced
by filing one copy of a Notice of Appeal wit ^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.
S-
U��Lfi&A
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR:
APPLICANT:
PROPERTY ADDRESS:
LOT: 7 BLOCK:
Park
PERMIT 4: 56-SF-1 948934
APPLICATION #:AP1413882
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1229233
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 1301-613-0042-000-5 [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 [ 1.050 ] GALLONS / GPD Seotle 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 [ 1
D [ 500 ] SQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [X] FILLED [ ] MOUNDS= -[,I
I CONFIGURATION: [X] TRENCH
N
F LOCATION OF BENCHMARK: Site BM2,
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: [17.001 INCHES
[ ] BED [ ]
NiD in
[
I
The system is sized for 4,bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated Flow of
400 gpd.
T
H
E
R
SPECIFICATIONS BY: HF'ian J Ingram li TITLE: Environmental Specialist II
POINT
POINT
APPROVED BY: En 'ronmental Specialist II St. Lucie CHD
Brian J Ingr
DATE ISSUED: 06/05/2019) EXPIRATION DATE: 12/05/2020
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, PAC Page 1 of 3
v 1.1.4 AB1413882 SE1178488
91 A-1
NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
administrative hearing pursuant to sections 120.669 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 hearirip within 21;.days'frorp receipt of this order will
constitute a waiver of your right to an admiri3i�'tra I've, he i g'`, nd.this order shall become a 'final
order'. i F .f. I r4 .,
Should this order become a final ord party who a Jr Q y affected by it is entitled
l.. ,.
to judicial review pursuant to Section 120.68, R
F rida, t tees" ?vie� proceedings are '
governed by the Florida Rules of Appellate Procedure. SZ roceedings 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.
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: (Wade Jurney Homes LLC)
PROPERTY ADDRESS: TSD Eastwood Dr Fort Pierce, FrLn349.`a1
LOT: 7 BLOCK: 138
PROPERTY ID #: 1301-613-0042-000-5
PERMIT #: 56-SF-1 948934
APPLICATION #:AP1413882
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1229233
, RANGE, PARCEL 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 Septic new CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY I ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
D [ 375 ] SQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD Ix] FILLED I MOUND [ ]
I CONFIGURATION: [x] TRENCH
N
F LOCATION OF BENCHMARK: Site BM2,
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: [ 17.001 INCHES
] BED [ ]
in Rd, S property line extended E
t2,Olh 1 13fiCHES' ; F�.,',]ij4ABOVE BELOW
73.001i ] [ TMIC�ESyi. �( FR�,� [A80VE BELOW
The system is sized for 4 bedrooms with a maximum
O 400 gpd.
for a total estimated Flow of
T
H
E
R
SPECIFICATIONS By:. Brian J In�g2 TITLE: Environmental Specialist II
POINT
POINT
APPROVED BY: /.�^�"TITLE: Environmental Specialist II St. Lucie CHD
Arian J Ing
DATE ISSUED: 06105/2019 EXPIRATION DATE: 12/05/2020
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 M1413882 SE1178488
✓" L
And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land In fee
simple; that the grantor has good right and lawful authority to sell and convey said land; that the grantor
hereby fully warrants the title to said land and will defend the same against the lawful claims of all
persons whomsoever; and that said land Is free of all encumbrances except taxes accruing subsequent to
December 31st of 2018.
In Witness Whereof, the grantor has hereunto set their hand(s) and seal(s) the day and year first
above written' .
Carlos Suarez Barbara Suarez
Signed, sealed and delivered in the presence of these witnesses:
Witness Signature `` Witness Signature
Print Name: `Q� fQ Print Name: n 2
State of Orr
County of 4,—',
The Foregoing Instrument was Acknowledged before me on Carlos
Suarez and Barbara Suarez, husband and wife who Is/are personally known tome or who
has/have produced i vacs license as Identification.
v
otary Public
(Printed Name)
My Commission expires: 2.6 144
4 Ay 0 F"42191
. a Fap�es: lx�sr 13. Y0f9
Page 2 of 2
2236 - 2570004
STATE OF FLORIDA ,
DEPARTMENT OF HEALTH
ONSITE. SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION -
APPLICANT: Wade Jurney Homes, LLC
191b-
APPLICATION # AP1413882
PERMIT # 56-SF-1948934
DOCUMENT # SE1178488
CONTRACTOR / AGENT:, Wade Jurney Homes, LLC
LOT: 7 BLOCK: 138 ,
SUBDIVISION: Lakewood Park ID#:1301-613-0042-000-5
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE
REGISTRATION NUMBER AND. SYGN AND SEALEACHPAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO•SITE PLAN: [X ]YES
[ ]NO
NET USABLE AREA AVAILABLE: ;. 0.27 .,.ACRES
TOTAL ESTIMATED SEWAGE FLOW:
400 GALLONS
PER DAY
[ RESIDENCES-TABLEI
/
OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW:
404.00: •GALLONS
PER DAY
[ 1500 GPD/ACRE,
OR
2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABL]ki
2600.00 SQFT
UNOBSTRUCTED AREA"REQUIRED:
750.00 SOFT
BENCHMARK/REFERENCE 'POINT LOCATION:
Site BM2, NID In Rd, S property
line extended E
ELEVATION OF PROPOSED SYSTEM SITE 2.00 CLINCHES / FT�] [ ABOVE / BELOW ] EENCM'MRK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: FT DITCHES/SWALES: ET NORMALLY NET [ ]YES [X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 80 FT NON -POTABLE: FT
BUILDING FOUNDATIONS:`• 5 FT - PROPERTY'LINES: 5 FT POTABLE WATER LINES: 65 FT
SITE SUBJECT TO FREQUENT'FLOODING? -,[ ]YES [X]NO 10 YEAR FLOODING? [ ]YES IXINO]
10 YEAR FLOOD ELEVATION FOR SITE: FT( MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE ,INFORMATION SITE 2
USDA SOIL SERIES:Lawnwood sand
Munsell #/Color Texture
Depth
I OYR 511
Sand
_ 0 To 9
1 OYR 6/1
Sand
9 To 34
1 OYR 711
Sand
25 To 34
10YR 512
Sand
34 To 43
1 OYR 2/1
Spodic Material -
43 To 63
10YR 314
Sand _
.63 To 72,
USDA SOIL SERIES:Lawnwood sand
Munsell #/Color Texture
Depth
10YR 511
Sand
'' 0 To 10
10YR 611
Sand
10 To 36
1 OYR 7/1
Sand
27 To 38
1 OYR 511
Sand
38 To 45
1 OYR 211
Spodic Material
45 To 61
10YR 313
Fine Sand
61 To 72
OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / EEI 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: INCHES
DRAINFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA
determined using USDA WES and soil borings.
1 stripping In 10YRS/I matrix, >10% with diffuse boundaries, starting at 25" In SI31
SITE EVALUATED BY:
Ingram —,-Brian (rule: Ironmental 5pncialistll) (ENVIRONMENTAL HEALTH)
DR 4015, 08/09 (Obsoletes previous editions which v not be used) Incorporated: 64E-6.001, FAC
AP1413882 EID1949934
DATE: 05/20/2019
Page 3 of 4
v 1.0.2
s C)
St. Lucie County Health Department
Y 5150 NW Milner Dr Port Saint Lucie, FL,34983.
HEALTH,
, 5
PAYING ON: a:56-SF-1948934 13ILLDOC#:56-BID-4185906. CONSTRUCTION APPLICATION#:'AP141J882
RECEIVED FROM: Wade Jurnev Homes, LLC AMOUNT PAID: $ 515.00
PAYMENT FORM: -;:.CHECK°"31774 PAYMENT DATE: 05/1312019
MAIL TO: (Wade Jurney Homes, LLC)
FACILITY NAME:
PROPERTY LOCATION:
M ,Eastwood, Dr
Fc'fpierce, FL 34951
Lot: 7 Black: 138
Property ID: 1301-613-0042-000-5'
EXPLANATION or DESCRIPTION:
QUANTITY
FEE
128 - OSTDS-Construction' System Inspection Research Fee
1
$
5.00
-1 - Surcharge (All)
1
$
15.00 '
-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: VanceMH AUDIT CONTROL NO. 56-PID-3940076
Note: Well 59-29548 $630.
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 App'Win the
appropriate District Court. The notice must be filed within 30 days of rendition of the final order..
L4 V, C/& I Ck
Dta 1q -11265-y P
STATE OF FLORIDA PERMIT NO. 5,F 19441
DEPARTMENT OF HEALTH DATE PA , ID:
ONSITE SEWAGE"TAEATMENT AND DISPOSAL
SALFEE, PAID:
SYSTEM � RECEIPT.#: e-4 Sj--7�7q
APPLICATION�,FOR CONSTRUCTION PERMIT
APPLICATION FOR: J,"..
New System Existing System Holding Tank:, [I ]Iilnnovative•,
Repair Abandonment Temporar
APPLICANT: i o'lOAIQ l�140� w
TELEPHONE:
♦cl
MAILING ADDRESS 10 - > rK. Y-'K I ti. f
-4P6
TO BE COMPLETE'b'BY"PLICANT'-OR'APPLICANT'S 'AUTHORIZED AGENT; . �SYSTEMS'MUA BE CONSTRUCTED
BY A PERSON LICENSED PURSUANT TO,489.105(3)'(m) OR,489.552i,, FLORIDA STATUTES,;' IT IS,, THE
APPLICANT'S RESPONSIBILITY;TO�IPROVIDE DOCUMENTATION OF THE, DATE THE.ROIT WAS CREATED.,,OR
' ' . -I "I I 1 01
PLATTED (MM/DD/Yi) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER, PROVISIONS.
PROPERTY INFORMATION
LOT: - I BLOCK: t3S SUBDIVISION: t, V-,-Vj1zATTED:
PROPERTY ID #:
SZONING:
I/M OR EQUIVALENT:
I Y / N I
PROPERTY SIZE:,Y
ACRES WATER
SUPPLY:
[>(] PRIVATE
PUBLIC [ ]<=2000GPD [
]>2000GPD
IS SEWER AVAILABLE AS PER 381.0065,
FS? I
Y / N
DISTANCE TO SEWER:
_,75___FT
PROPERTY ADDRESS:
DIRECTIONS TO PROPERTY: S�
BUILDING INFORMATION r>(] RESIDENTIAL [ ] COMMERCIAL
Unit Type of No. of Building Commercial/Institutional System Design
No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
N
I'A
00,
3
4
Floor/Equipment Drains Other (Specify)
Dti
ATE:
DH 4015, 08/09 (Obsoletes previous edxNk&bns which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
b�h Lft0CA
STATE OF FLORIDA
DEPARTMENT OF -HEALTH
ONSITE SEWAGE, TREATMENT AND DISPOSAL ,
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: (Wade Jurney Homes, LLC) Fr 7
�1
PROPERTY ADDRESS: TBD Eastwood Dr ' FF
PERMIT p:56-SF-1948934
APPLICATION fl:AP1413882
DATE PAID:.
-FEE PAID:
'RECEIPT q:
DOCUMENT #:-PR1229233
LOT: 7 BLOCK: 138 k , SVBDfIpS57C1 : `n tali' Wood Park
["ER
.` r �(; [SECTION, TOWNSHIP,,RANGE, PARCEL NUMBER]
PROPERTY ID 9: 1301-613-0042-OOD-5 f ,[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 MATEAIAL FACTS,
WHICH SERVED AS AI BASIS FOR ISSUANCE OF "THIS PERMIT, -REQUIRE THE APPLICANS 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 N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
H [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS 8[ ]DOSES PER 24 HRS 8pumps [ ]
D [ 500 ] SQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [X] FILLED [] MOUND,
I CONFIGURATION: [X] TRENCH f ] BED [ ] '..�,% tki
F Locamxox of BENCHMARK: Site BM2, NiD in Rd,-Spr4,'jrt5?Jine ertentied t
I ELEVATION OF PROPOSED SYSTEM SITE [ 2'.'d� ;}�[ INCHES
E BOTTOM OF DRAINFIELD TO HEINCHES; i F] [
L 'V
D FILL REQUIRED: [17.001 INCHES EXCAIIIVA•••TTON REQUIRED:
r
The system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per.bedroom), for a total estimated flaw of
0 400 gpd.
T
H
E
R
SPECIFICATIONS BY: Sian J Ingram ,,-7 TITLE: Environmental Specialist II
POINT
POINT
APPROVED BY: :En 'sonmental Specialist II St. Lucia CHD
Brian J Ingr
DATE ISSUED: 06/0512019 EXPIRATION DATE: 12/05/2020
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 AP14139e2 SE1178488
"PAI
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: S�OSTDS New �
APPLICANT: (Wade Jurney Homes, LLC)
PROPERTY ADDRESS: TBD Eastwood Dr Fort Pierce. G6349551
PERMIT n:56-SF-1948934
APPLICATION ]):AP1413882
DATE PAID:
FEE PAID:
RECEIPT fl:
DOCUMENT -a: PR1229233
LOT: 7 BLOCK: 138 $OBD �` ON; ;j Lakirwsotl FI$iic ; „il
f'r ('� .} 61 Pik i9N
}1:s1,p :[SECTIONy�TQ, SHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 1301-613-0042-000-5 i'r:m Y t hx -1 _
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 Sentic 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 Drainfield new SYSTEM
R [ 7 SQUARE FEET N/A SYSTEM _
A TYPE SYSTEM: [ ] STANDARD [x] FILLED [7 MOUND [ ] _
I CONFIGURATION: [R] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: Site BM2,,NiD in Rd, $:property line extended E
I ELEVATION OF PROPOSED SYSTEM SITE a2. e0,J 7 [ 10CHE5� Ff.'j;(1k
OVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE �J3.00 ] I QNC>�ES FT j [-ABOVE [BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [17.001 INCHES XCAVATION.REQUIRED: :[:' ] INCHES
IThe system is sized for 4 bedrooms with a maximum b1.
$cuparicy, of 8 persons, (2 per bedroom), for a total estimated flow of
O 400 gpd.
T
H
RI
SPECIFICATIONS BY:. Brian J In2t Z.TITLE: Environmental Specialist II
APPROVED BY: LE: Environmental Specialist II St. Lucie CHD
Brian J Ing
DATE ISSUED: 06/05/20191 EXPIRATION DATE: 12/0512020
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, PAC Page 1 of 3
v 1.1.4 AP1413882 SE1178488 /XM
✓ L
RECEIVED
PERMIT #:56-SF-1948934
STATE OF FLORIDA OCT 2 9 2019 APPLI CATION #:AP1413882
DEPARTMENT OF HEALTH IATE PAID:
ONSITE SEWAGE TREATMENT AND DIS OSSTALucie County, Permitting FEE PAID:
SYSTEM
RECEIPT #:
DOCUMENT #: PR1229233
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: (Wade Jumey Homes LLC)
PROPERTY ADDRESS: TBD Eastwood Dr Fort Pierce, FL 34951
LOT: 7 BLOCK: 138 SUBDIVISION: Lakewood Park
PROPERTY ID #: 1301-613-0042-000-5 [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 [
1,050 ]
GALLONS / GPD Septic 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 HER #Pumps [
D [
500 3
SQUARE FEET Drainfield new
SYSTEM
R [
]
SQUARE FEET N/A
SYSTEM
A TYPE SYSTEM: [ ] STANDARD [x] FILLED
[] MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: Site BM2, NID in Rd, S property line extended E
I ELEVATION OF PROPOSED SYSTEM SITE [ 2.00 ][ INCHES FT ](ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 3.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D
0
T
H
E
R
system is size fFEFN4)bedraom ith a maximum occupancy of 8 persons (2 per bedroom), fora total estimated flow of
gpd.
1
SPECIFICATIONS BY: Brian J
APPROVED BY:
DATE ISSUED:
TITLE: Environmental Specialist II
DH 4016, 08109 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
v 1.1.4 A 1413882
II
St. Lucie CHD
EXPIRATION DATE: 12/05/2020
SE1178488
Page 1 of 3
l��OLo1
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.
ti+l•i jy(ib.; F.�
.foYia
HEALTH
PAYING ON:
RECEIVED FROM
PAYMENT FORM:
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
#:56-SF-1948934 13lLLooc#:56-BID-4185906 CONSTRUCTION APPLICATION #: AP1413882
Wade Jurney Homes, LLC AMOUNT PAID: $ 515.00
CHECK 31774 PAYMENT DATE: 05/13/2019
MAIL TO: (Wade Jurney Homes, LLC)
FACILITY NAME:
PROPERTY LOCATION:
TBD Eastwood or
Fort Pierce, FL 34951
7
Lot:
Property ID: 1301-613-0042-000-5
EXPLANATION or DESCRIPTION:
138
Block:
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 $
15.00
1 $
100.00
1 $
100.00
1 $
115.00
1 $
55.00
1 $
75.00
1 $
50.00
RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-3940076
Note: Well 59-29548 $630.
0
STATE OF FLORIDA
DEPARTMENT OF HEALTH
y� ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[ ] New System [ ] Existing System [ ] Holding Tank
[ ] Repair [ ] Abandonment [ ] Temporary
APPLICANT:
V,ia 15 •255-y F
PERMIT NO. S.331
DATE PAID:
FEE PAID: T3D�
RECEIPT #: f K 31 "7714
[ ] Innovative
AGENT: .., .. — \e 1. �-JJTELEPHONE:
/I- a',) ,�e-(1.LLS
MAILING ADDRESS: ��� ��/{'�"'
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.
1! j:T0 4 al S§_W 4 1 k i� l9[a)ii;ds40 tom
LOT: _ BLOCK: 13 SUBDIVISION: C(.'S-AQ C.SL—)C��C� PLATTED:
PROPERTY ID #: (70` -.(Q!'7) �C7C74��("G� JZONING: I/M OR EQUIVALENT: [ Y / N ]
PROPERTY SIZE: '---t ACRES WATER SUPPLY: [x] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? I Y / N ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS:
DIRECTIONS TO PROPERTY: c SA4�'e `,4✓
BUILDING INFORMATION [')(] RESIDENTIAL [ ] COMMERCIAL
Unit Type of No. of Building Commercial/Institutional System Design
No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
1 �15 1-:� �:j _L of
2
3
4
[ ] Floor/Equ)pment Drains [ ] Other (Specify)
DR 9015, 08/09 (Obsoletes previous edkibns which may not be used)
Incorporated 64E-6.001, FAC
DATE:
Page 1 of 4
STATE OF FLORIDA APPLICATION # AP1413882
DEPARTMENT OF HEALTH PERMIT # 56-SF-1948934
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1178488
APPLICANT: Wade Jurney Homes LLC
CONTRACTOR / AGENT: Wade Jurney Homes LLC
LOT: 7 BLOCK: 138
SUBDIVISION: Lakewood Park ID#: 1301-613-0042-000-5
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: 0.27 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY . [ I RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 404.00 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 2000.00 SQFT UNOBSTRUCTED AREA REQUIRED: 760.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Site BM2. NID in Rd. S DrooertV line extended E
ELEVATION OF PROPOSED SYSTEM SITE 2.00 [ INCHES / £T ] [ ABOVE / BEIAW ] BENCHMMRK/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: 80 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT
SITE SUBJECT TO FREQUENT FLOODING?
10 YEAR FLOOD ELEVATION FOR SITE:
SOTT. PROFTT.E TNRORMATTON 4TTR 1
PROPERTY LINES: 5 FT POTABLE WATER LINES: 65 FT
]YES [X]NO 10 YEAR FLOODING? E ]YES [X]NO]
FT [ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
USDA SOIL SERIES:Lawnwood sand
Munsell #/Color Texture
Depth
10YR 5/1
Sand
0 To 9
1 CYR 6/1
Sand
9 To 34
10YR 7/1
Sand
25 To 34
1 CYR 5/2
Sand
34 To 43
10YR 2/1
Spodic Material
43 To 63
1 CYR 3/4
Sand
63 To 72
QnTT. DR(1RTT.7. TMPnRMDTTnM CTTF. 9
USDA SOIL SERIES:Lawnwood sand
Munsell #/Color Texture
Depth
10YR 5/1
Sand
0 To 10
1 CYR 611
Sand
10 To 36
1 CYR 7/1
Sand
27 To 38
10YR 5/1
Sand
38 To 45
10YR 211
Spodic Material
45 To 61
1 CYR 313
Fine Sand
61 To 72
OBSERVED WATER TABLE: 72.00 INCHES [
ABOVE / BELOW ] EXISTING GRADE
TYPE:
[ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION:
25 INCHES [ ABOVE
/ Piz;; ]
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)
r REMARKS/ADDITIONAL CRITERIA
determined using USDA WSS and soil borings.
1 stripping In 10YR611 matrix, >10% with diffuse boundaries, starting at 26" In SB1
SITE EVALUATED BY:
Ingraa-m-,ffrian (Tille: ironmental Specialist 11) (ENVIRONMENTAL HEALTH)
DH 4015, 08/09 (Obsoletes previous editions whioh Y not be used) Incorporated: 64E-6.001, PAC
INCHES
DATE: 05/20/2019
Page 3 of 4
AP1413882 EID1948934 v 1.0.2