HomeMy WebLinkAboutSewageSTATE OF FLORIDA
.DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: John R. & Gina Marie Whitaker
PROPERTY ADDRESS: 5004 Pinetree Dr Fort Pierce, FL 34982
PERMIT #; 56-SF-2049617
APPLxcATxoN #: AP1474740
DATE PAID;
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1321217
LOT: 17 & 18 BLOCK: 3 SUBDIVISION: Indian River Estates
PROPERTY ID #: 3402-602-0099-000-1 [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 I ]'GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY I ]GALLONS 0[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 375 ] SQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE'SYSTEM: [ ] STANDARD I ] FILLED [x] MOUND
I CONFIGURATION: [XI TRENCH [ ] BED [ ]
y
F LOCATION OF BENCHMARK: Site BM set NiD, W side of Rd, S property line extended W, elev 16.67
I ELEVATION OF PROPOSED SYSTEM SITE [ 9:00 ][INCHES FT ][ABOVE BELOW BEN
E BOTTOM OF DRAINFIELD TO BE 17.00 ][INCHES FT ][ABOVE BELOW BEN
L
7
0
T
H
E
R
system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
gpd•
POINT
POINT
SPECIFICATIONS BY: Brian J I amTITLE; Environmental Specialist II
c
APPROVED BY: TITLE: Environmental Specialist II St. Lucie CHO
Brian J In am
DATE. ISSUED: 04/01/2020 - EXPIRATION DATE- 10/01/2021
DH 4016, 08/09 (Obsoletes all previous editions which may not be used) AG
Incorporated: 64E-6.003, FAC 666DDD ® ge 1 of 3
v 1.1.4 AP1474740 SE1 lie
o
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 governedby 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.
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
PAYING ON: #:56-SF-2049617 BILL Doc#:56-BID-3604959 CONSTRUCTION APPLICATION#:AP1474740
RECEIVED FROM: Alexander J. Piazza PSM, Inc John Erick AMOUNT PAID: $ 545.00
PAYMENT FORM: CHECK 1703 PAYMENT DATE: 03/20/2020
MAIL TO: John R. & Gina Marie Whitaker
FACILITY NAME:
PROPERTY LOCATION:
5004 Pinetree Dr
Fart Pierce, FL 34982
3
Lot: 17 & 18 Block:
.Property ID: 3402-602-0099-000-1
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
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
31aol2oao 8ll RRt4A-t U'V4-
RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-4344268
4 STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
PERMIT NO.
DATE PAID: 3IJUI
FEE PAID: '-
RECEIPT #:
New System [ ] Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair [ ] Abandonment[ ] Temporary [ ]
APPLICANT: John R. & Gina Marie Whitaker
AGENT: Alexander J. 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: 17&18 BLOCK: 3 SUBDIVISION: Indian River Estates Unit I PLATTED: 1956
PROPERTY ID #: 3402-602-0099-000-1 ZONING: R I/M OR EQUIVALENT: [ No ]
PROPERTY SIZE: 0.978 ACRES WATER SUPPLY: [,0] PRIVATE PUBLIC [I)(] <=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: 5004 Pinetree Drive, Fort Pierce, FL 34982
DIRECTIONS TO PROPERTY: SEE MAP
BUILDING
Unit Type of
No Establishment
I RESIDENCE
F6
3
4
[vel RESIDENTIAL [ I COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms AreaSgfgft Table 1, Chapter 64E-6, FAC
3J,95�
[ ] Floor/Equipment Drains Other (Specify) GARBAGE GRINDERS/DISPOSALS
Alexander J Piazza �^ sP°�rt
SIGNATURE : mkzom.otn irwueas® DATE: 2-12-20
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
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'4 STATE OF FLORIDA PERMIT #. JrG•S�?o�(�/Celi
DEPARTMENT OF HEALTH
p/ ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
Kam' SITE EVALUATION AND SYSTEM SPECIFICATIONS
APPLICANT: John R.& Gina Marie Whitaker AGENT: Alexander J. Piazza PSM, Inc.
LOT: 17&18 BLOCK: 3 SUBDIVISION: Indian River Estates Unit I
PROPERTY ID #: 3402-602-0099-000-1 [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: 0.978
ACRES
TOTAL ESTIMATED SEWAGE FLOW:
500
GALLONS
PER DAY [RESIDENCES-TABLEI/OTHER-TABLE2
]
AUTHORIZED SEWAGE FLOW:
GALLONS
PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE
]
UNOBSTRUCTED AREA AVAILABLE:
750
SQFT
UNOBSTRUCTED AREA REQUIRED: 750
SQFT
BENCHMARK/REFERENCE POINT LOCATION:
ELEVATION OF PROPOSED SYSTEM SITE IS34 [INCHES/FT ] [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: 100 FT
BUILDING FOUNDATIONS:5 FT PROPERTY LINES: 10 FT POTABLE WATER LINES: FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES I✓] NO 10 YEAR FLOODING? ] ] YES [✓] NO
10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD
evil, ravxC Lz iM,
MUNSELL #/COLOR
J14`l X1 VLA c1xz 1
TEXTURE
USDA SOIL SERIES:
DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
OBSERVED WATER TABLE:40+ INCHES [BELOW
ESTIMATED WET SEASON WATER TABLE ELEVATION:_
HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO
SOIL PROFILE INFORMATION SITE 2
MUNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
(] EXISTING GRADE. TYPE:[ PERCHED/ APPARENT ]
_ INCHES [.ABOVE/BELOW ] EXISTING GRADE
MOTTLING: [ ] YES [ ] NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION
DRAINFIELD CONFIGURATION: I✓] TRENCH [ ] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA:
INCHES
Alexander Piazza w�SR°v^��°
SITE EVALUATED BY: ,w eimam.,i�>•3amasov DATE: 2-12-20
DH 4015, 12/11 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 Of 4
APPLICANT'S NAME: John R. & Gina Marie Whitaker .Ugvice f7
LEGAL DESCRIPTION: Lots 17 & 18, Block 3i Indian River Estates Unit 1
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 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.
nyae. vm a Dw.vKUl,AlexanderJ PiazzaaZnia.. .sseixucve°°°°xs°x.
[mRleuMerlTma
CERTIFIED BY:
FLORIDA PROFESSIONAL NO.: 6330
DATE: 02/12/20 JOB NO.: 20-5127
dots/Forms/septics/SepticApppPage207