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Home My WebLink AboutSewagePERMIT #:56-SF-2091221 ay�,rj,,bx� APPLICATION #: AP1509928 STATE OF FLORIDA QW DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: SYSTEM RECEIVE) CONSTRUCTION PERMIT FOR: OSTDS New RECEIPT: AUG 19 2020 OCUMENT #: PR1380291 ST. Lucie County, Permitting APPLICANT: (United Pentecostal Fire Ministires Trinity International Inc.) PROPERTY ADDRESS: 202 E Midway Rd Fort Pierce, FL 34982 t. I + LOT:, 21& 22 BLOCK: 38 SUBDIVISION: Indian, aver 18i es; PROPERTY ID #: 3402-605-0135-000-5 [SECTION, TOWNSHTP, [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381j0065, 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 SeDtiC new CAPACITY A [ ] GALLONS / GPD CAPACITY N [ ] GALLONS GREASE. INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps D [ 750 ] SQUARE FEET Drainfield new - ' SYSTEM R [, ] SQUARE FEET A TYPE SYSTEM: [ ] STANDARD I CONFIGURATION: [ ] TRENCH N F LOCATION OF BENCHMARK: Orange Sp I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D 0 T H E R [x] FILLED [x] BED SYSTEM [ ] MOUND [ ] SE corner of canal [ 3.00 ] [ INCHES FT ] [ ABOVE BELOW BENCM-M T /REFERENCE POINT [ 7.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE-'POINT gallon dosing tank required if lift dosing is necessary to achieve drainfield elevation. SPECIFICATIONS BY: Brian J I�p am TITLE. Environmental Specialist II APPROVED BY: TITLE: Environmental Specialist II Brian J gram DATE ISSUED: 07/29/20 EXPIRATION DATE DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC v 1.1.4 AP1509928 SE1339093 St. Lucie CHD 01 /29/2022 Page 1 of 3 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) 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 f nal 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. `i St. Lucie County Health Department I'(F(8 5150 NW Milner Dr Port Saint Lucie, FL 34983 HEALTH PAYING ON: #: 56-SF-2091221 BILL ooc #:56-BID-4728465 CONSTRUCTION APPLICATION #. AP1509928 RECEIVED FROM: Ladko Desiqn Group, LLC AMOUNT PAID: $ 545.00 PAYMENT FORM: CHECK 7102 PAYMENT DATE: 06/15/2020 MAIL TO: (United. Pentecostal Fire Ministires Trinity International Inc.) & FACILITY NAME: .5uK („yg Ila7y��-1� (�Z PROPERTY -LOCATION: 202 E Midway Rd Fort Pierce, FL 34982 21 & 22 Lot: 38 Block: Property ID: 3402-605-0135-000-5 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 RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-4453395 S �S STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL ' SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: PERMIT NO. SF-,Z.b%,/?Z) DATE PAID: :J i-l.5,00 FEE PAID: !0 a RECEIPT #: [✓] New System [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ 7 APPLICANT: United Pentecostal Fire Ministries Trinity International, Inc. AGENT: Richard Ladyko, P.E. - Ladylco Design Group, LLC TELEPHONE: 772-530-8261 MAILING ADDRESS: 4400 Belle Grove Drive, Ft. Pierce, Florida 34981 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: 21 & 22 BLOCK: 38 SUBDIVISION: Indian River Estates, Unit 4 PLATTED: PROPERTY ID #: 3402-605-0135-000/5 ZONING: I I/M OR EQUIVALENT: [ No ] PROPERTY SIZE: 0.92Ac. ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [ ✓ ]<=2000GPD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: 202 East Midway Road, Ft. Pierce, Florida 34982 DIRECTIONS TO PROPERTY: U.S. Highway #1 to Midway Road, go east approx. 1/2 mile. Property is on the north side of Midway Road, approx. 200 ft. west of Buchanan Drive BUILDING INFORMATION [ ] RESIDENTIAL [ ✓] COMMERCIAL Unit Type of No Establishment 1 Religious Facility 2 3 4 No. of Building Commercial/Institutional System Design Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC N/A 3,931 s.f. 3.0 g.p.d. x 150 seats = 450 g.p.d. [ ] Floor/Equipment Drains [ ] Other (Specify) SIGNATURE: �, -'yl( DH 4015, 08/Q(9 (Obsoletes previ.ou's editi ns which may not be used) Incorporated 64E-6.001, FAC DATE: 6®15- rz®ze) Page 1 of 4 Z•0•l. 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