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Home My WebLink AboutSewage'1 r _ Po„ STATE OF FLOIjIDA PERMIT NO. 'Sf • ��03 DEPARTMENT OF HEALTH DATE PAID: B'16'L01d uQ, ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: 'q fir' SYSTEM RECEIPT APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [X] New System [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT: . David Agler AGENT: Culpepper & Terpening, Inc. TELEPHONE: 772-464-3537 MAILING ADDRESS: 2980 South 25th Street, Ft. Pierce, FL 34981 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: 10 BLOCK: 172 SUBDIVISION: Lakewood Park, Unit 12A PLATTED: 1959 PROPERTY ID #: 1301-615-0093-000-3 ZONING: RM-5 I/M OR EQUIVALENT: [ Y IfI PROPERTY SIZE: 0.22 ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [X ]<=2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y /�N )] DISTANCE TO SEWER: _VA FT PROPERTY ADDRESS: 5120 Sanibel Avenue DIRECTIONS TO PROPERTY: -192 feet Southwest of the intersection of Sanibe Winter Garden BUILDING INFORMATION [X] RESIDENTIAL [ ] COMMERCIAL Unit Type of No Establishment 1 Single Familv Res `' 3 4 No. of Building Commercial/Institutional System Design Bedrooms Area Sq£t Table 1 Chapter 64E-6, FAC 3 1359 S.F. [ ] Floor/Equipment Drains [ ] Other (Specify) a SIGNATURE: ......... DATE: 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 SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: David Agler CONTRACTOR / AGENT: Culpepper & Terpeninq, Inc. LOT: 10 BLOCK: 172 SUBDIVISION: Lakewood Park ID#:1301.615-0093-000-3 APPLICATION # AP'1473723 PERMIT # 56-SF-2048103 DOCUMENT # SE1268838 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: 0.22 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 329.99 GALLONS PER DAY [ 1500 GPD/ACRE j OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 750.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00` SQFT HENCHMARK/REFERENCE POINT LOCATION: Site BM Set ELEVATION OF PROPOSED SYSTEM SITE 3.00 [ N//DD on asphalt paving west of Sanibel Ave. aES 1/ 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: 68 FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 11 FT POTABLE WATER LINES: 44 FT SITE SUBJECT TO FREQUENT FLOODING? 10 YEAR FLOOD ELEVATION FOR SITE: nTT. rDnVTi4 TMCnaMnmTnM CTMV t [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NOI FT [ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD USDA SOIL SERIES:Lawnwood Munsell #/Color sand Texture Depth 1 OYR 5/1 Sand 0 To 23 1OYR 6/1 Sand 21 To 36 10YR 2/1 Spodic Material 36 To 45 7.5YR 313 Sand 45 To 60 1 OYR 3/2 - Sand 60 To 67 10YR 5/3 Loamy Sand 67 To 72 unmTnM CrmC 9 USDA SOIL SERIES:Lawnwood sand Munsell #/Color Texture Depth 1OYR 411 Sand 0To8 10YR 5/1 Sand 8 To 22 10YR 611 Sand 22 To 25 10YR 211 Sand 25 To 37 10YK 211 Spodic Material 37 To 44 7.5YR 3/3 Sand 44 To 60 1 OYR 3/2 Sand 60 To 68 10YR 513 Loamy Sand 68 To 72 OBSERVED WATER TABLE: 70.00 ESTIMATED WET SEASON WATER TABLE INCHES [ ABOVE / BELOW ] EXISTING GRADE ELEVATION: 21 INCHES [ ABOVE TYPE:. / BELOW ] [ PERCHED / APPARENT ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 21.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: DE4INFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY) - REMARKS/ADDITIONAL CRITERIA WSWT determined using USDA WSS and soil borings. 10YR 6/1 stripping in 10YR 5/1 matrix> 10%with diffuse boundaries starting at 21" In SBG1. SBt 3" below BM. SB2 4" below BM. SITE EVALUATED BY: INCHES DATE: 03/26/2020 Collier, Hunter (Title: Environmental Speclalisel) (Florida Department or neann In ar. L DR 4015, 08/09 (obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 AP1473723 EID2048103 v 1.0.2 ESTATE OF FLORIDA 'DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM , CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: David Agler PROPERTY ADDRESS: 5120 Sanibel Ave Fort Pierce, FL 34951 PERMIT #:56-SF-2048103 APPLICATION #:AP1473723 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1319430 LOT: 10 BLOCK: 172 SUBDIVISION: Lakewood Park [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] PROPERTY ID #: 1301-615-0093-000-3 [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 THI 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 Seotic 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 61 ]DOSES PER 24 RRS #Pumps [ ] D [ 375 ] SQUARE FEET Drainfield New SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X] MOUND [ ] I CONFIGURATION: [X] TRENCH N F LOCATION OF BENCHMARK: Site BM set I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D F 0 T H E R [ • ] BED [ ] N/D on asphalt paving west of Sanibel Ave. [ 3.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT [ 0.00 ][ INCHES FT I GABOVEq BELOW] BENCHMARK/REFERENCE POINT - Wuitt U; L c i.uvj ayu: J NAG V"Xun .. Wuitt U: L a 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: Hunter A Collier TITLE: Environmental Specialist I APPROVED BY: \ ] LE: Environmental Specialist I St. Lucie CAD Eunter A Collier DATE ISSUED: 03/31/2020 EXPIRATION DATE: 09/23/2021 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 AP1473723 SE1268838 NOTICE OF RIGHTS r-ti 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. Q .