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HomeMy WebLinkAboutSewageSTATE OF FLORIDA y�T"e,r,r DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ,) r,71 1 -117) APPLICATION FOR SEPTIC TANK PERMIT +, I I .,� �ti;� • ,c" "' ' ' AND FINAL INSPECTION FORM r •a�,..� Authority: '6�= 3,e . Chapter 381, 366, 387, FS �,t P,wjQ Chapter 1oD-6,AE LUCIE COUNTY* h DATE y�_� HEALTH UNf�; Permit Number _ , Name of Applicant �9L i/U le Telephone No. _' ZS1, Z Mailing Address of Applicant 571- . . ST ,Zgf %"5 L. 'To Be Installed At: (Give Street Ad ress)• .z Do S. -. 411 Lot No. _//�)44 Block No. Subdivision 2'r- f l '/ et Book e 9 Z Pa 35, S 27 SZl prf , Size of Lot. t �'E' By 2o42 - No, Living Units No, Bedrooms No. People i. Type of Business-.P�oFfSS• 3 . No. T *lets -3 . - No: Wash Basins No, Employees Total Square Feet in Building 2 2 '� `Note: Attach Site Location Map and Other Supportive Documents D `� �, • �' S• I SD N d'��`�G• Signature f Applicant 7v Ly,ceZ Co V4c G -;C'- §ITE INFORMATION .•��.., Distance to Sanitary Sewer----..---.,, Distance to Stream, Lake, Canal Distance to Public Water Supply • A V,411Z iSL1�' Distance to Private Wells) Rainfall Data:_ % D'` 2 Is Area Subject to Flooding 7 __ /L)O Does Site have Good Natural Drainage? —.- Which Way Does Lot Drain ?_._._Ta Fie®-vT Any Perimeter pitches?. ?• 515' Depth of Ditches Is there Standing Water in Ditches? - WO ' Depth of Water in Ditches Distance to Nearest Residence (North - East °'e'f South-- 3 d' West -- Are Buildings in this Area on: Septic Tanks e%�s' Sand Filters — Other Any Known Drainfield Failures in this Area ti D SOIL PROFILE AND PERCOLATION DATA 12" �'a St1tiP %-�... Water Table At- inches w 24" Hard Pan . At inches . j Z a 3V �. Clay At — Inches 0 6!' __ Muck At _�...Inches CY _J 48•0 ° Other A Inches �G Soil Classification: 601• Percolation Rate: M 4 riL; IN TALLATION SPECIFICATIONS Septic Tank Capacity:, Drain, Tile (Linear Ft.): - Dosing Tank Capacity: ' t �;'� Sand Filter Size, (Sq,Ft.). Grease Trap Capacity: Absorbfion Bed Size: (Sq.Ft.) Perforated Pipe: (Lineal Ft.) Lateral Drainfield Size: (Sq.Ft.) _ Other Specifications:___ I i RECOMMENDATION: , :Approval approval date Processed Ana re of Sanitarian - County Health Department ANAL INSrt:GI IUN UA7A Date an ime of In3pection Type of Tank (Concrete; Fiberglass, Etc;) Size Tank Installed . • - • ' nrainfield Size - No, Tile Feet Dosing Tank Size- ..Grease TrapSize `` Sand Filter Seze Who Made Installation---t-" 9 RECOMMENDATION: A Poval , n pp ®Disapproval l WRS-H FORM 4016, AU948 6 128) Signature of Sanitarian i ; ' i' • ` 2d ,J / jv SEPTIC TANK CONSTRUCTION PERMIT Ilat�lf�t4,itrtt ti��t; Ii4' 14V;�4CCCfiC�`-Wi�l1 r''.191f�"+"s 199�€a3elaa?{°p r a✓ 'f ! s 1 s t 1 ' i1,,1 s L+F,... �, s.t. 1^^�� r••� r'�3 7 7- F r... { y .r°t �^ °s r ��" ! t� its, .+i P�'��k- ftrr u sf ,� }i,t Yfu tittA . t tr Log+ � r, h 6S m r tbVa 6' s �' 2E .'E 'i'��.'� .fie �•. t'U"ra�l•'��gg99��F� �.e��id5 -. ^ /t � :;i1 rGf J- ij tti` f �,::• ,.;3 r G� !t A{; 2,.� 741.�!�' oA%xdk:� iagpl6*d a,'�,ki.,� J.7".Fr 7 r x :,. 1,._l ;. ..,,,,.�: n. d;'^,`- �7 y1.�1, 5. y3in+ •.� ti t ems' t .q t ;;,t 5 ++�t�,��Y.'�i jT jxrQ73x'r: 4U111iiIl��� 4l n1'a s A i� 1 r a i � xl r .sr` Y �('..• t y` ,�., A . ,v. !, p+ `: � � '�� e. t r �;<: k hxi S3. 4 r�?� f.,�.�i�.�S�ji�t�`h��•�ryYr.�,yr�t�i*�'t^ts��y�'r'K7 x�,�; a :.Y> lea ,Yi }3Y0�k!(r .I}.:+Gti3GPisYGi'iE 4aL��J . rdR �p "Yr,eY�� "��3I'6a J�kCaCws: . t erk n �a,; ?t+vi ;rl j t..Y'f S r'G✓ P+ � tt 9.i. ,s 1. ,�,� 'q !r?., 1' sv In.<F dr �-t. �-F+�ni4.d.r i�°}',,r �F ;h �11 Ely i r,t ... .., ,s t� ,, •. -➢{'.. ,n � t ;, 5of e.:,Jt 5"J i:y{l et., }fi f+,. irgyl ttsdt. ri 'I,YE„l�i�`si. '�"d{4Y � ! t t , • ��d� !O��ie'r 1, , . � y lti � .��k�4 �. 4 ( � r r ? � � � t N Xt i�„n s � i?ln�Ja f r� t(d ,P, �i h '✓ r Y ., !„ ,. v: i • '� It `1:. d i�t..�.i}<t' � a`"tl ry��y �G�SYS }•"'.s�t�•4Epa ���1 ���` i��T'�ui �' $'tle:i4 {i'�I s' •.� , ) _) r ..t i r1 �� � � `11� ` " .tiS !�Y t+.Iw�4 �V7 �1>;��! ,IN it'��' jl�r+��\f �� '�^�di�11��32�'"t��f�t`l t��: ' ; � . r , � i .I' 1 . tr); t r-Fr v,_ �.,� �,s. Wf1 Y ' S1�r-�tt •^k A�����St%�>F(�s�..�"�y ��r„}f4 'Y Y:; '• i t .. .; i ae- ,.,:1 5 , . � .. xl ... 3,. k 3° ,..rc...,r. n h, r ship ecorded lorida;� _I �.. 11T::-- 1` I Tad'/� -1 r�.._ _.� ..� , a �� i,.F_.. ,1.,._.v, I�!-/ o w: ; -, s . i F. 1 _ S :LE , iT I 1 I Commencing r at• " the Hang Northwest e:i 40«:;l i corner 'of Lot' 4; ; 131ock, ' 4; ` of Se Plat 5�:-.-. _ 5:7 -South' ;_ ast;.l.._}.accordin _.'to � the of L l �.n I.. plat ' Book j 1; ,Pale ; �35, : of . ;the ::'Public! ;Records v�. S thence South along I 'the West ' line of said, Lot 4 :£tar "i 111 a I cti T oven-� Ubx3 G1lRD3 0P) 9 as luciit !County, a di st wice1 of 225 l ;feet to the ! pOIlyx r 01 1 BEGINNTNH,I thence; East : and . parallel to, the North ;line of ;said Lc t 4 'for ! a dist ante of '190.16 „ feet to , ;the Westerly; ' RIGHT-OF-W, of U. S.. r, ;IIighway..� I�b.' �1, !then6; southeasterly ' along said' westerly RIGATOP WAY f � a dist- '_� �arice..,of100:..' feet, ,:.thence: We' t.; to .1.saa.d.' North., line. i..for : fa ` distrance. of 235.6Y j j f eet I . it o� the ` Nest line o f ; pad ; Lot 4; . thkene©'North ` ong;. }said';;, �ire'at ; lino ,.far { a ; distance ,of ; 88.5 , feet' , to I the P0TI1'; I of 18EGIATEN ;Cant6a.niin9l 0@43es jjjl more. �o I ;less• Inotes fisting Ii:mprovoments i and' }possible encroachments j axe nb shovrri has I they sxa be _.aI 11 , A_Lj T �aERj3 {QEFfi'I ghat the,!, abod oi5KLT1'C,a of: �Ui�VE'l'!:.,.. �s i. true.;c2�d; ccirrect i o t;he, y. . 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