HomeMy WebLinkAboutHealth Department Septic Approval RECEIVED APR, 04 7.017 PERMIT #:56-SF4740061 STATE. OF FLORIDA APPLICATION *:AP1276012
E; ^, DEPARTMENT OF HEALTH DATE PAID:
t �^ ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID:
SYSTEM RECEIPT #
DOCUMENT # PR1051077
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Vaske&Kristina Cluperger
►' PROPERTY ADDRESS: 15370 Skyking Dr Port Saint Lucie,FL 34987
LOT-: 67 BLOCK: SUBDIVISION: Treasure Coast Air Park
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 4224-501-006M00-5 [OR TAX ID NUMBER]
SXSTEM 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 [ 1,200 ] GALLONS / GPD SBDtic new CAPACITY
A [ ] GALLONS / GPD NIA CAPACITY
GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K j ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 767 ] SQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X] MOUND [ ]
T CONFIGURATION: [ ] TRENCH [X] BED [ ]
N
F LOCATION OF BENCHMARK: FND PK and disk in rd(no id)in cut out.painted pink S property
I ELEVATION OF PROPOSED SYSTEM SITE [ 19.00 ] [ INCHES FT j [ABOVE BELOW BENCHMARK/REFERENCE POINT
( E BOTTOM OF DRAINFIELD TO BE [ 17.001C INCHES FT I ABOVE BELOW BENCHMARK/REFERENCE POINT
L `
D FILL REQUIRED: [20.00] INCHES EXCAVATION REQUIRED. [ 66.001 INCHES
r The system is sized`for 3.bedrooms with a maximum occupancy of 6 persons'(Z per bedroom),for a total estimated flow of
0 460 gpd•
T The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with
M H
S,64E-6.013(3)(f), FAG.
. E
i23
--SPECIFICATIONS BY: Brian J Ingram TITLE: Environmental Specialist II
APPROVED BY: TITLE: Environmental Specialist II St.Lucie CHD
Brian J lrolram
DATE ISSUED: 02124/2017 EXPIRATION DATE: 08/24/2018
DH 4016, 08/09 .(Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, PAC Page 1 of
rn1276012 ssiozaaas
FU �:
a
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 28-1:06, Florida Administrative Code. A petition for
i 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
ClerWs,facsim le number is 880-413-8.74.3.
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 shalt 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.
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I St. Lucie County Health Department.
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HEALTH5150 NW Milner Dr Port Saint Lucie,- FL $4983
PAYING ON: PERMIT#-56=SF-17.4,0061 BILL 00C#:56-B1D-3347339 CONSTRUCTION APPLICATION#AP1276012
RECEIVED FROM: Vaske&Krisbna Cluperger AMOUNT PAID; $515.00
PAYMENT FORM; CHECK 306 PAYMENT DATE: 02/15/2017
MAIL TO: Vaske&Kristina Cluperger
FACILITY NAME.:
PROPERTY LOCATION:
15370 Skyking. Dr
Port.Saint Lucie,FL-34981
Lot: 67 Block:
w
Property ID: 4224501-0067-000-5
EXPLANATION or DESCRIPTION: QUANTITY FEE
A -_O.STDS Construction Application and Plan Review,New 1 $ 100.00
1.23-OSTDS Construction Site Evaluation 1 $ 11500
126-OSTDS Construction Permit(New or Mod, Amendment) 1 $ 55.00
127-OSTDS Construction System Inspection 1 $ 750Q
128-OSTDS.Construction System Inspection Research Fee 1 $ 5.00
133-OSTDS Construction Reinspection 1 $ 50.00
-1 -Surcharge(All) 1 $ 15.00
-1 -OSTDS New Permit Surcharge 1 $ 100.00
RECEIVED BY- VanceMH AUDIT CONTROL NO: 56-PID-8184683. '
f 7
I J
214 o `7
STATE OF FLORIDA' ERRMIT No. 1711L
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATIMENT AND DISPOSAL FEE PAID:
4 SYSTEM. RECEIPT #: ,
ApPi,ZCATxOIV FOR C<}NSTRi3C3'Z(}N PERMIT 0 U_-
.AP ICATION FOR.-
[ ] New System [ ] Existing System [ ] Holding Tank [. ] Innovative
]' Repair [ ] )Abandonment [ ] Teiuporary
1 [
A-pBLiCANT• /� `a' �171 S a.>>.�
AGENT: TELEPHONE: (
MAILING ADDRESS: / y Nam, �� ye P SL... .
TO BE COMPLETED BY APPLICANT R; APPLICANTrS AUTHORIZED AGENT. SYSTEMS MUST BE` CONSTRtIftkD
BY A-PERSON L-ZCENSED PURSUANT TO 4R9.105(3) f4ij 012 489.652; FLORIDA STATOTES. IT IS THE.
•APPLICANV S RESPONSIBILITY TO PROVIDE, DOCMdENTATION OF THE' DATE THE LOT WAS CREATED OR
PLATTED (MM/DD/Yr-) IF REQUESTING GONSIDERATiou OF STATUTORY GRANDFATHER PROVISIONS.
PROPERTY INFORMUION `
TOOT:. d BLOCK: SUBDIVISION: --712e4.S(7f�e 4OLP7- l`pzATTEbs 'c .
PROPERTY rD: #: 7'�� .5d : ' s
ZONING I/t1 OR. EQUIVALENT: [ Y / N ]
PROPERTY SIZE: -/s S ACRES WATER SUPPLY: [x�7 PRIVATE PUBLIC [ ]�<=2000GPD [ ].>U.00GPD
IS SEWER AVAILABLE AS PER 381..0065, F8? [ Y //aj DISTANCE T.O: SEWER: /U FT
PR0FE12TY ADDRESS _kl hS. j772 d v,e ;
DIRECTIONS TO PROPERTY: 1Y-�e&
l 0 ray?-
klo
BUILDING INFORMATION Ix
�1 U.RE81 ENTi [ j Gobfimc u
Unit Type of Noo._of . Building Commercial/Institutional Systeru Design
No Establishment Bedrooms Area Sqft Table 1,. Chapter 64E-6, E'AC
xe
2
- 3 _
4
a Floor%Squ "m ` rai J er (Speoify)
SIGNATURE: / DATE.:
DS 4015:,, 08/00 (Obsoletes previ ou., ditions whieh may not be used)
Incorpora:tedd64E=6.001, FAC Page of 4
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STATE OF FLORIDA APPLICATION # AP1276012"
DEPARTMENT OF HEALTH
PERMIT # 56-SF .740061
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1024446`
—APPLICANT: VasK.q&Kristina Cluperger
CONTRACTOR / AGENT": VaSke.&KriStina Cl.uperger
LOT:: 67 BLOCK:
SUBDIVISION: Treasure Coast Air Park ID#: 4224-501-0067-000-5
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: g 30 ACRES
TOTAL ESTIMATED SEWAGE. FLOW: 450 GALLONS PER DAY [ RESIDENCES-TABLET I/ OTHER-TABLE 2 ]
AUTHORIZED SEWAGE FLOW; 1$950s00 GALLONS PER DAY [ 150"0 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1200.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1150.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: FND PK and disk in rd(no id)in.Cut out..painted,pink S.property, _
ELEVATION OF PROPOSED SYSTEM SITE 19.00 [ INCHES / FT ] [ ABOVE / BEIAW j BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: 10.0, FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [X]NO
WELLS.: PUBLIC: FT LIMITED USE: FT PRIVATE: 75 FT NON-POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 15 FT POTABLE WATER, LINES: 40 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ].YES [X]NO]
10 YEAR FLOOD ELEVATION FOR SITE: FT [ MSL / NGVD I SITE ELEVATION-: FT [ MSL / NGVD
SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2
"USDA SOIL SERIES:Wabasso sand USDA SOIL SERIES:Wabasso sand
Munsell#/.Color Texture Depth Munsell#/Color Texture Depth
16YR 3/1 Sand 0:To 11 10YR 411 Sand 0 TO 12
10YR 511 Sand 11 To 16 1 OYR 5/1 Sand 12 To 16
i 0YR:611 Sand l ff To 28 10YR 6/1 Sand 16 To 28
10YR 3H Sand 28 To 33 10YR 3/1 Sand 28 To 33 7.
1 OYR:3/2 Sandy Clay Loam 33 To"43 10YR 4/2 Sandy Clay Loam 33 To 43
1 OYR 5/2 Sandy Loam 43 To 66
1OYR 5/2 Sandy Loam 43 To 66'
1 OGY 6/1 Loamy Sand 66 To 72
I 1 OGY 511 Loamy Sand 66 To 72
09SERVED WATER TABLE: 72,00 INCHES [ ABOVE 'BEE] EXISTING, GRADE TYPE: [ PERCHED / APPARENT
ESTIMATED WET SEASON WATER TABLE ELEVATION: 22 INCHES [ ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE 'VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 22.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.60 DEPTH OF EXCAVATION: 66 INCHES
DRAINFIELD CONFIGURATION: [ ] TRENCH [XI BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA
WSWT determined using UDSA WSS and soil borings.
10YR7/1 stripping:in 10YR6M matrix>40%with diffuse boundaries starting at 22"in SB2.
SB.1 17"'below'BM:SB219"below ON%
SITE EVALUATED BY: -+�+ DATE: 62I24/2017
Ingram,Bria . (tle:Environmental Specialist 11)(ENV.IRONMENTAL HEALTH)
DH 4015,. 09/09 (obsoletes previous editions which may not be used) Incorporated: 64E-6.001„ FAC Page 3 of 4'
AP1276012 EID1740061 v 1.0.2
r
oFT"E o� STATE OF FLORIDA PERMIT
"tt sr DEPARTMENT OF HEALTH
fig•, ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
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APPLIC. T•: SIL/ / 1�%/N ��UP(/�� AGENT:
LOT: 7 BLOCK: SUBDIVISION:
-PROPERTY ID #:_ 22�" Ol- S%(07'O�C7 [Section/Township/Parcel No;. or Tax ID Number]
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTEMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINNEERS
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: ACRES
TOTAL ESTIMATED SEWAGE FLOW: GALLONS PER DAY [RESIDENCES-TABLE I/.OTHER-TABLE21
AUTHORIZED SEWAGE FLOW: GALLONS PER DAY (1500 GPD/ACRE 09. 2'500 GPD/ACRE.]:
UNOBSTRUCTED AREA AVAILABLE: SQFT UNOBSTRUCTED AREA REQUIRED: SQFT
ENCHMART REFERENCE POINT LOCATION':,' P p),f
ELEVATION OF PROPOSED SYSTEM SITE IS; 2�f INCHE./FT] [ABOVE ELQ�L]:` REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: FT DrITCHES/SWALES: /S FT NORMALLY WET? [ ) YES [ ] NO
WELLS PUBLIC: 20 C3 .FT LIMITED USE: 1tpc_0 FT PRIVATE '7 5" FT NON-POTABLE.: S'0, FT
BUILDING FOUNDATIONS: FT PROPERTY LINES: S FT POTABLE WATERRLINES: 10 FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ ] NO 10 YEAR FLOODING? [ ) YES [ ] "NO
10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD.
SOIL: PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2
MUNSELL #/COLOR TEXTURE` DEPTH MUNSELL 4/COLOR TEXTURE DEPTH
TO TO
TO TO
TO TO
TO :TO
TO TO
TO TO
TO TO
TO TO
TO TO
USDA SOIL SERIES: USDA SOIL SERIES`:
t OBSERVED WATER TABLE: INCHES ['ABOVE / BELOW] EXISTING GRADE. TYPE: [PERCHED / APPARENT]
ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [ABOVE / BELOW] EXISTING GRADE
UIGH 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 [ J OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA:
SITE EVALUATED BY: DATE:4
bg: 4015,, 08/09 (Obsoletes previous editions vrhich may t be used) Incorporated: 64E-6.001,EAC Page 3 of 4
Property Card Page 1 of 1
sr. 1*1go64,1
Michelle Franklin, CFA--Saint Lucie County Property Appraiser--All rights reserved.
Property Identification
Site Address,.,15370 Parcel ID:4224-501-0067- Account#: 125829 Sec/Town/Range:
'SKYKING'DR 00065 24/37S/38E
yy Map ID:42/29X Zoning:AG-5 Use Type:0000 Jurisdiction:Saint Lucie
County
Ownership Legal Description
Vasile Ciuperger TREASURE COAST AIRPARK LOT 67(9.43 AC)(OR 3894-
Kristina:Ciuperger 1818)
293 Berenger Walk]
WELLINGTON,FL 33414.
Current Values Historical Values 3-year
Just/Market: $84,900 Assessed: $84,900 Year Just/Market Assessed Exemptions Taxable
Exemptions: $0 Taxable: $84,900 2016 $84,900 $84,900 $0 $84900
2015 $80,400 $80,400 $0 M0,400
2014 $80,400 $80,400 $0 $80,400
Sale History
Date Book/Page Sale Code Deed Grantor. Price
07-21-2016 3894/•1'818 0001 WD McCarty IV Daniel T $75,000
12=22-201'0 3256/0234 0316 SP McCarty IV,Daniel T $69,600
12-22-2008 30.47/0051 XX03 PB McCarty Ill(EST),Daniel T $0
Primary Building Information
_ Finished Area of this building:,0 SF
Gross Area of this building:0 SF
Exterior Data
View: Roof Cover: Roof Structure: Building Type:
Year Built:NIA Frame: Grade: Effective Year:2014
Primary Wall; Story Height: No.Units:0 Secondary Wall:
Interior Data
Bedrooms:0 A/C 6/a:0% Electric: Primary Int Wall:
Full Baths:0 Heated%:N/A% Heat Type: Avg.Ilgt/Floor:0
Half Baths:0 Sprinkled%:0% I1eat Fuel: Primary Floors:
Total Areas
Finished/Under Air 0
eke:€! (SF.):
(r?(YS,i'grr;r(3i{ Gross.Area(0); 0
for ^�; Land Size(acres): 9A3
"!r;' "�) Land Size(SF): 41:0;7708
Total Building Count: I
Special Features and Yard Items
Type Qty Units Year"Blt
This information is.believed to be correct at this time but it is subject to change and is not warranted.
d Copyright.2017 Saint Lucie County Property Appraiser.All rights reserved.
http://www.pa8lc.org/RECard/ 2/15/2017