HomeMy WebLinkAboutSewageSTATE' OF FLORIDA PERMIT #.
r ` e DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL, SYSTEM
Al' SITE EVALUATION AND SYSTEM SPECIFICATIONS
APPLICANT: ppaf 1, �UG'l �' jl i> AGENT:
LOT: BLOCK: SUBDIVISION:
— -�
PROPERTY ID #:_ 3y(? a.5[Section/Township/Parcel No.1 r Tax ID Nu .er'f`J
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: [4 YES [ ] NO NET USABLE AREA AVAILABLE: 0,6Z ACRES
TOTAL ESTIMATED SEWAGE•FLOW: 400 GALLONS PER DAY [RESIDENCES -TABLE 1/OTHER-TABLE23
AUTHORIZED SEWAGE FLOW: 30 GALLONS PER DAY [1500 GPD/ACRE OR 2500 GPD/ACRE]
UNOBSTRUCTED AREA AVAILABLE: p SQFT UNOBSTRUCTED AREA REQUIRED: X /S SQFT
BENCHMARK/REFERENCE POINT LOCATION:_
ELEVATION OF PROPOSED SYSTEM SITE IS
YUlN•r
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: /_"; FT DITCHES/SWALES: 13 FT NORMALLY WET? [ ] YES LAI, NO
WELLS: PUBLIC: %/: FT LIMITED USE: /u( FT PRIVATE /JS_ FT NON -POTABLE: -- FT
BUILDING FOUNDATIONS:_ % FT PROPERTY LINES: %/ FT' POTABLE WATER LINES: 71r, FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [fQ NO 10 YEAR FLOODING? j ] YES. [xj NO
10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD
SOIL PROFILE INFORMATION SITE 1
MUNSELL #/COLOR TEXTURE
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
bull, YHUFI:L,E INFORMATION SITE 2
MUNSELL #/COLOR TEXTURE DEPTH
TU
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
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: DEPTH OF EXCAVATION: INCHES
DRAINFIELD CONFIGURATION: [ ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA: Gt/ —r_aZ Nor (71S'S�i�(�F/�1 Di/fz�r✓/` 3I i/.J7iT'
SITE EVALUATED BY:
L R ic#Ago C
DR 4015, 08/09 (Obsoletes previous editions V
M
. [�v;�6?•; l43/1
tins _-not be used) IncoFpo[ated: 64E-6.001, FAC
DATE: 3 12 7 Z
Page 3 of 4
STATE OF FLORIDA APPLICATION # AP1481802
DEPARTMENT OF HEALTH PERMIT # 56-SF-2059570
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1298623 .
APPLICANT: Port St. Lucie Properties, Inc
CONTRACTOR / AGENT: Laventure & Associates Inc
LOT: 24, 25, 26, 27 BLOCK:
SUBDIVISION : ID# : 3404-805-0024-000-4
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 AVAILABLE: 0.62 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 929.99 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1000.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1000.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Site BM set naiUtin tab CL of road
ELEVATION OF PROPOSED SYSTEM SITE 6.00 [ 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:. 75 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 7 FT PROPERTY LINES: 11 FT POTABLE WATER LINES: 62 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES EX ]NO 10 YEAR FLOODING? [ ]YES [X]NO]
10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD] SITE ELEVATION: FT [ MSL / NGVD
SOIL PROFILE INFORMATION SITE 1 SnTT. PRnPTT.P TUPnRMAmTNa QTMW o
USDA SOIL SERIES:Ankona sand
Munsell #/Color Texture
Depth
10YR 4/2
Sand
0 To 6
10YR 511
Sand
6 To 11
10YR 6/1
Sand
11 To 25
10YR 7/1
Sand
24 To 34
10YR 2/1
Spodic Material
34 To 38
7.5YR 3/3
Sand
38 To 41
1 OYR 211
Spodic Material
41 To 45
1 OYR 711
Sand
45 To 53
10YR 3/1
Sand
53 To 72
USDA SOIL SERIES:Ankona sand
Munsell #/Color Texture
Depth
10YR 5/1
Sand
0 To 15
10YR 611
Sand
15 To 25
10YR 7/2
Sand
25 To 44
10YR 2/1
Sand
44 To 70
1 OYR 6/3
Sand
70 To 72
OBSERVED WATER TABLE: _INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE:
ESTIMATED WET SEASON WATER TABLE ELEVATION: 24. INCHES [ ABOVE / HELOW ]
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 ]
EXISTING GRADE
DEPTH: 24.00 INCHES
Sand/0.80_ DEPTH OF EXCAVATION: 45 INCHES
] BED [ ] OTHER (SPECIFY)
SWT determined using USDA WSS and soil borings. 10YR 711 stripping in 10YR 6/1 matrix > 10% with diffuse boundaries starting
24" in SB1. SB1 6" above BM. SB2 7" above BM.
SITE EVALUATED BY:
Collier, Hunter (Title: Environmental Specialist 1) (Florida Department of Health in St. L
DH 4015, 08109 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC
DATE: 05/20/2020
Page 3 of 4
AP1481802 EID2059570 v 1.0 2
w
qQ
STATE OF FLORIDA PERMIT NO . r
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID:
',y�oDcf' SYSTEM RECEIPT #:
APPLICATION FOR CONSTRUCTION PERMIT,���
APPLICATION FOR:
New System [ ] Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair [ ] Abandonment [ ] Temporary [ ]
APPLICANT:
AGENT: LA TELEPHONE: —/;;
MAILING ADDRESS: 5 Z ��E9`�ZS. ZC24 t9 > L L/f I.:�> I�eA pis
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: BLOCK: SUBDIVISION: J �r �i�9/IIES SLI�JIjlf/;�-.I PLATTED:
PROPERTY ID #: 3LIO'1-005 00049` 0(ij) ZONING: jZ "j I/M OR EQUIVALENT: [ Y / N ]
PROPERTY SIZE: L;:G'L ACRES WATER SUPPLY: [,�4] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y /�) DISTANCE TO SEWER: i ILe,)V FT
PROPERTY ADDRESS: yyp (iOr'y`tiG. F- D(Lc ''ens-lp
DIRECTIONS TO PROPERTY: t���i''itTl it'r�3 -rqF 1k')%-2-' OF h= ,423A11-0 (JL�✓�>a'��
r .r-
Go i-�� o�,i G�Pez`� /%!D% i�='� %{Di r�1,�7�=�`r� f�� I� c f is Sig �iJ 'rzic-'i �i'�5!✓�,
I
BUILDING INFORMATION
Unit Type of
No Establishment
[,<] RESIDENTIAL [ ] COMNMRCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter•64E-6, FAC
7,
2
3
4
[ ] Floor/Equipment Drains [ ] Other (Specify)
SIGNATURE:
DH 4015, 08/09 (Obsoletes pi
Incorporated 64E-6.001, FAC
ist!?w ;-Gil"'✓. �',�3 � L •; S ��x°
edit-ons which may not be used)
DATE: 1717 j Z0
Page 1 of 4
r
HEALTH
PAYING ON:
RECEIVED FROM:
PAYMENT FORM:
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
#: 56-SF-2059570 BILL HOC #:56-BID-4650262 CONSTRUCTION APPLICATION #: AP1481802
Laventure & Associates Inc AMOUNT PAID: $ 660.00
CREDIT CARD 732197 PAYMENT DATE: 04/30/2020
MAIL TO: (Port St. Lucie Properties, Inc)
FACILITY NAME:
PROPERTY LOCATION:
TBD Gopher Ridge
Fort Pierce, FL 34982
Lot: 1 24, 25, 26, 27
Property ID: 3404-805-0024-000-4
EXPLANATION or DESCRIPTION:
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
-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
RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-4368549
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) day5from 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: (Port St. Lucie Properties, Inc)
PROPERTY ADDRESS: TBD Gopher Ridge Fort Pierce, FL 34982
LOT: 24, 25, 26. 27 BLOCK: SUBDIVISION:
PROPERTY ID #: 3404-805-0024-000-4
PERMIT #:56-SF-2059570
APPLICATION #: AP1481802
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1349508
[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 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]
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 set nail/tin tab CL of road
I ELEVATION OF PROPOSED SYSTEM SITE [ 6.00 ][ INCHES FT ]( ABOVE BELOW] BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 6.00 J[ INCHES FT ] ABOVE BELOW]BENCHMARK/REFERENCE POINT
L
Di
0
T
H
E
R
REQUIRED: [16=1 INCHES EXCAVATION REQUIRED: [ 45.00] INCHES
system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of
gpd.
SPECIFICATIONS BYHunter A Collier
APPROVED BY: 11��.R�\LE
Hunter A Collier
DATE ISSUED: 05/29/2020
TITLE: Environmental Specialist I
Environmental Specialist I
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
St. Lucie CHD
EXPIRATION DATE: 11/21/2021
Page 1 of 3
v 1.1.4 AP1481802 SE1298623