HomeMy WebLinkAboutHealth Department Septic Approval JTs`: Rick Scott
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March 24,-2017
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David Hall
1040 Pulitzer Road
Fort Pierce,FL 34945
RE:Modification to•a Single Family Residence-:No Bedroom Addition
Application Document Number: AP1282453
Centrax.Permit Number: 66-SF-1749749
1040 Pulitzer Road
Fort Pierce,FL 34946
Dear Applicant,
This will acknowledge receipt of a floor:plan and site plan on.03123l2017 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property.
This office has reviewed end verified the floor plan and site plan you submitted.,forithe proposed
remodeling addition or modification to:your single-family home. Based on the information you.provided,
the Health Department concludes:
1. the proposed remodeling addition or modification is.not adding a bedroom; and
2. it does not appear to-cover any part of the existing system or encroach on the required setback
or unobstructed area.
3. Nonexisting system inspection or evaluation and assessment, or modification,replacement,or
upgrade.authorization is required.
Because an inspection or evaluation of the existing septic.system-was not:conducted,'the Department
cannot attest.to the existing system's current condition,size,oradequacy to.serve the proposed use.
You may request a voluntary inspection and:assessment of your:system from a licensed,septic tank
contractor or plumber,.or a person certified under section 381.010.1, Florida Statutes.
If you have any questions, please call our office at(772)873-4:931.
Sincerely,
Dianna May
Environmental Specialist I
Department of Health in.St.Lucie County
FlorldaDapar6tet!of 1116at16 - wwrsllorldt6tttl6.yw
In St.Lucie County•5150 NW Milner:Drive•Port Saint Lucie,Florida TWITTER:HealftFLA
34983 FACEBOOKTI-DepartmentofHealth
PHONE (772)-873-4931 YOUTUBE:Odoh
St. Lucie County Health Department
z 5150 NW Milner Dr Port Saint Lucie, FL 34.983
HEALTH
PAYING ON: PERMIT.#:56-SF-1749749 BILL ooc#:56-13I13-3366109 CONSTRUCTION APPLICATION#:AP1282453
RECEIVED FROM: David Hall AMOUNT PAID:
PAYMENT FORM: CASH PAYMENT DATE: 03/23/2017
MAIL TO: Loren David Hall
FACILITY NAME :
PROPERTY LOCATION:
1040 Pulitzer Rd
Fort Pierce,FL 34945
Lot: Block.-
Property ID: 2317-221-0020-000-4
EXPLANATION or DESCRIPTION: QUANTITY FEE
139- OSTDS Application Approval Existing, No Insp 1 $ 35.00
RECEIVED BY: CarroIIJR AUDIT CONTROL NO. 56-PID=3202816
:STATE OF a,ORIDA PERMIT NO. F 7 7yq 1 y /
DEPARTMENT OF HEALTH DATE PAID
ONSITE .SEWAGE =ATNENT AND 'DISPOSAL FEE PAID
�arwove+*`fi" SYSTEM RECEIPT #: o _
APPI,7CATION FOR CONSTRUCTION 'PERMIT
APPLICATION FOR:
[ ] New System [#41 Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair [ ] Abandonment [ ] Temporary [ ]
APPLICANT: �6"�NQW aid d^�a�! .uQ.�( D����c�J•(�.DrJ.
AGENT: ® / •� TELEPHONE: ??a`!�9G�If-.010 9
MAILING .ADDRESS: A? 0- As 0 2 j Q:Q1Q !, 101erre fly J r lt�j
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: BLOC SUBDIVISION:UBDIVISIOON: PLATTED:
PROPERTY ID *:a3/N A l-00d.0 -OQV ZONING: G-5 I/M bR :EQUIVALENT: [ Y/N ]
PROPERTY SIZE: 3 .ACRES WATER SUPPLY: [ ArRIVATE PUBLIC [6-]<=2000GPD .[ 1>2000GPD
IS SEWER AVAILABLE AS PER 3381.00 1V/.65, FS? [ Y/J 7 DISTANCE TO SEWER: FT
PROPERTY ADDRESS: A0 `"J Aylj Aer (CAd.. F)r Ar !/'Lf Af J f9f--5�
DIRECTIONS TO PROPERTY: 0-4 je AV re / a 41
An Ile
BUILDING INFORMATION [�RESIDENTTflT, [ ] COMMERCIAL
Unit Type of No.. of Building Commercial/Institutional System Design
No Establishment j 'Bedrooms Area Sgft 'Table 1, Chapter 64E-6, FAC '
1 ���� SOPt.�•jy Alf ��. 1
2
3
4
[ 7 Floor/Equipment Drains [ ] Other (Specify)
'SIGNATURE: -le DATE: 5116117
DE 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
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