HomeMy WebLinkAboutHEALTH DEPARTMENTSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Wade Tindall
PROPERTY ADDRESS: 11652 Orange Ave Fort Pierce, FL 34945
LOT: 1 BLOCK: SUBDIVISION:
PROPERTY ID #: 2309-210-0000-000-9
PERMIT #:56-SF-2221496
APPLICATION #:
AP1613242
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #:
PR1521258
[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 [ 1,200 1 GALLONS / GPD Septic new CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ j GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 767 1 SQUARE
FEET
Drainfield new
SYSTEM
R [ ] SQUARE
FEET
N/A
SYSTEM
A TYPE SYSTEM:
[ ]
STANDARD [ ] FILLED
[x] MOUND
I CONFIGURATION:
[ ]
TRENCH [x] BED
[ ]
N
F LOCATION OF BENCHMARK:
RP Nall in N side Of pine tree S side of house.
I ELEVATION OF PROPOSED SYSTEM SITE [ 27.001
E BOTTOM OF DRAINFIELD TO BE [ 21.00 ]
L
`7
0
T
H
E
R
[ j
FT ][ABOVE AMLOW 0 BENCHMARK/REFERENCE POINT
FT ][ABOVE TBELOW I BENCHMARK/REFERENCE POINT
.Vvy a U; J L9.UUJ INCH s EXCAVATION REQUIRED: [ 4/ UU J 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 BY: TITLE
Brian J Ingr m : Environmental Specialist III
APPROVED BY: `i^^•�-- TITLE: Environmental Specialist III St. Lucie
Brian J In ram
CHD
DATE ISSUED: 03/16/202 EXPIRATION DATE: 09/16/2022
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 A 1613242 SE1488662
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 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.
St. Lucie County Health Department
'gip c' 5150 NW Milner Dr Port Saint Lucie, FL 34983
HEALTH
PAYING ON: #:56-SF-2221496 BILL DOC#56-BID-5153067 CONSTRUCTION APPLICATION#:AP1613242
RECEIVED FROM: Wade Tindall AMOUNT PAID: $ 545.00 _
PAYMENT FORM: CHECK 1364 PAYMENT DATE: 01/14/2021
MAIL TO: Wade Tindall
FACILITY NAME :
PROPERTY LOCATION
11652 Orange Ave
Fort Pierce, FL 34945
1
Lot: Block:
Property ID: 2309-210-0000-000-9
EXPLANATION or DESCRIPTION:
QUANTITY
FEE
128 - OSTDS Construction System Inspection Research Fee
1
$
5.00
-1 - Surcharge (All)
1
$
45.00
-1 - OSTDS New Permit Surcharge
1
$
100.00
-1 - OSTDS Construction Application and Plan Review,New
1
$
100.00
123 - OSTDS Construction Site Evaluation
1
$
115.00
126 - OSTDS Construction Permit (New or Mod, Amendment)
1
$
55.00
127 - OSTDS Construction System Inspection
1
$
75.00
133 - OSTDS Construction Reinspection
1
$
50.00
RECEIVED BY: AdamsC AUDIT CONTROL NO. 56-PID-4857180
cf n;e sr,
STATE OF FLORIDA
% DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
PERMIT NO. F C—/.-F 1"A L.(�
DATE PAID:
FEE PAID s
RECEIPT #:
f,f] New System [ ) Existing system [ ) Holding Tank ( ) Innovative
[ ] Repair [ ] Abandonment C ] Temporary [ J
APPLIM
AGENT;
MAILING
?s
TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MOST BE CONSTRUCTED
BY A PERSON LICENSED PURSUANT TO 489.105(3)(m) OR 4'89.552, 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: _I BLOCK: SUBDIVISION: e�To [� C 4-T T5 PLATTED;
PROPERTY ID /4:7 IInn0D-),/0-6000 000-7ZONING: A6 �-(- I/M OR EQUIVALENT: ( YIN J
PROPERTY SIZE-: Vs� f ACRES WATER SUPPLY; K) PRIVATE PUBLIC [ ]4x2000GPD [ ]52000GPD
IS SEWER AVAILABLE AS PER 3811.0065, FS7 [ YIN J DISTANCE TO SEWERsSs FT
PROPERTY ADDRESS: �J L- U��J n� Q((�[1� $'C� �YJY�
� DIR'E%CTIONSQ T%o-4ePROPERTY. n
�.1�(l e-4 '1�/l-0,4 1
BUILDING INFORMATION [ ] RESIDENTIAL [ I COMMERCIAL
Unit Type of No. of Building Commercial/Institutional System Design
No Establishment Bedrooms Area 5/sgftty Table 1, Chapter 64E-6, PAC
3.
3
4
[ J Floor/Equipment Drains [ ] Other
SIGNATUREt
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC
DATEi
Page 1 of 4
i
STATE OF FLORIDA APPLICATION # AP1613242
DEPARTMENT OF HEALTH PERMIT # 56-SF-2221496
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1488682
APPLICANT: Wade Tindall
CONTRACTOR / AGENT: Wade Tindall
LOT: 1 BLOCK:
SUBDIVISION: ID#: 2309-210-0000-000-9
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: 82.63 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 460 GALLONS PER DAY [IR SIDENCES-TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 123945.01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1500.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1150.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: RP Nall In N side Of pine tree S side Of house.
ELEVATION OF PROPOSED SYSTEM SITE 27.00 [ 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: 100 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 100 FT POTABLE WATER LINES: 100 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO]
10 YEAR FLOOD ELEVATION FOR SITE: FT [ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
SOTT. PRnVTT.R TNTY ATTON CTT .. 1 SOTT. PROFTT.R TNFORMATTON SITE 2
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
1 OYR 3/1
Sand
0 To 12
1 OYR 5/2
Sand
12 To 26
1 OYR 6/2
Sand
18 To 26
1OYR 2/1
Spodic Material
26 To 30
1 OYR 3/2
Spodic Material
30 To 34
1 OYR 5/4
Sandy Clay Loam
34 To 42
10YR 6/2
Sand
42 To 68
1 OYR 4/2
Sand
68 To 72
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
1 OYR 4/1
Sand
0 To 7
1 OYR 5/1
Sand
7 To 25
1 OYR 6/1
Sand
18 To 25
1 OYR 2/2
Sand
25 To 31
7.5YR 3/2
Spodic Material
31 To 35
1 OYR 6/3
Sandy Clay
35 To 47
1OYR 6/3
Loamy Sand
47 To 52
1 OYR 5/3
Sand
52 To 61
10YR 414
Loamy Sand
61 To 72
OBSERVED WATER TABLE: 58.00 INCHES [ ABOVE / HELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 18 INCHES [ ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 18.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.60 DEPTH OF EXCAVATION: 47 INCHES
DRAINFIELD CONFIGURATION: [ ] TRENCH [XI BED [ ] OTHER (SPECIFY)
7 REMARKS/ADDITIONAL CRITERIA
JSWT determined using USDA WSS and soil borings.
0YR6/2 stripping in 10YR5/2 matrix >10% with diffuse boundaries starting at 18" in SB1.
81 27" below BM. S82 28" below BM.
SITE EVALUATED BY:
Ingram, Brian us: Environmental Specialist III) (ENVIRONMENTAL HEALTH)
DR 4015, 08/09 (Obsoletes Previous editions hich may not be used) Incorporated: 64E-6.001, FAC
AP1613242 EID2221496
DATE: 03/08/2021
Page 3 of 4
1.0.2
Michelle Franklin, CFA-- Saint Lucie County Property Appraiser --All rights reserved.
Property Identification
Site Address:11652 Parcel ID: 2309-210-0000- Account #: 13260 Sec/Town/Range:09/35S/39E
ORANGEAVE 000-9 Map ID: 23/09N Zoning: AG-1 Count
Use Type: 6000 Jurisdiction: Saint Lucie
County
Ownership Legal Description
Tindall Holdings II LLC 9 35 39 E 1/2 OF NW 1/4-LESS RD R/W AS IN PB 22-16 AND
201 Campbell RD LESS THAT PART MPDAF: BEG N 1/4 COR OF SEC, TH S 00
Fort Pierce, FL 34945 33 01 E 40 FT, TH N 74 59 29 W 155.70 FT TO N LI OF SEC,
TH S 89 52 38 E ALG N LI 150 FT TO POB- (82.63 AC -
3,599,363 SF) (OR 3862-2900; 3919-2630)
Current Values
Historical Values 3-year
Just/Market: $465,224 Assessed: $91,323 Year
Just/Market
Assessed Exemptions
Taxable
Exemptions: $0 Taxable: $91,323 2020
$465,224
$91,323 $0
$91,323
2019
$396,624
$22,723 $0
$22,723
2018
$396,960
$22,743 $0
$22,743
Sale History
Date
Book/Page
Sale Code Deed Grantor
Price
08-31-2016
3919 / 2630
0130 WD Environmental Land Development
$255,800
Inc
04-26-2016
3862 / 2900
0001 WD AA Roach investment Ldt Part
$350,000
12-20-2002
1680 / 1025
XX04 WD AA Roach Mgt Corp
$3,300
Primary Building Information
Finished Area of this building: 0 SF
Gross Sketched Area:3,240 SF
View:
Year Built: 2019
Primary Wall: Wood/Sheath
Bedrooms: 0
Full Baths: 0
Half Baths: 0
Roof Cover: Sheet Metal
Frame:
Story Height: 1 Story
A/C %: N/A%
Heated %: N/A%
Sprinkled %: N/A%
Exterior Data
Roof Structure: Gable
Grade: FarmUTA
No. Units: N/AN/A
Interior Data
Electric:
Heat Type:
Heat Fuel:
Building Type: FarmUtil
Effective Year: 2019
Secondary Wall:
Primary Int Wall:
Avg Hgt/Floor: 0
Primary Floors:
Total Areas
Finished/Under Air
(SF):
Gross Sketched Area
(SF):
Land Size (acres):
Land Size (SF):
Total Building Count:
Special Features and Yard Items
Type Qty Units Year Blt
m
5,304
82.63
3,599,363
3
All information is believed to be correct at this time, but is subject to change and is provided without any warranty.
0 Copyright 2021 Saint Lucie County Property Appraiser. All rights reserved.
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Mission:
To protect, promote & improve the health
of all people in Florida through integrated
state, county & community efforts.
C IWd Yy I Yu.
HEALTH
Vision: To be the Healthiest State In the Nation
Ron DeSantis
Governor
Scott A. Rivkees, MD
State Surgeon General
Florida Department of Health in St. Lucie County
Conditions for Issuance of Water Well Permits
Effective July 24, 2017
Contact the Florida Department of Health in Saint Lucie County (FDOH — St. Lucie)
prior to constructing or abandoning any well.
a. Call the FDOH — St. Lucie Well Line at 772-873-4936 or email
SLCDOH-WELLS(DFLHEALTH.GOV
b. Provide the following information:
i. Permit number
ii. Driller name
iii. Address
iv. Date and time to begin construction/abandonment
• A minimum of 24 hours' notice is required before constructing any public water supply
wells. Please call our main office at 772-873-4931 and speak with Environmental
Health Staff or provide notification by email to SLCDOH-WELLS a FLHEALTH.GOV
• Submit revisions to permit and/or site map and associated fee within 48 hours of well
construction or abandonment.
Florida Department of Health
St.515 Lucie county Accredited Health Department
seas E: 72146ner Drive • Port : 72/87Lude-5 34983 Public Health Accreditation Board
PHONE: 772/462-3800 •FAX: 7727871-a360
StL ucieCo untyHealth.com
�ili1'st� STATE OF FLOWDA PER118TAPPLICATION TO CONSTRUCT,
•+ ° r+' \ REPAIR, MODIFY, ORASANDONA WELL
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2.0. Indleete total numhnr
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Michelle Franklin, CFA— Saint Lucie County Property Appraiser --All rights reserved.
Property Identification
Site Address:11652 Parcel ID:2309.210-0000- Account#:13260 SectTown/Range:09/35S/39E
ORANGE AVE 000-9 Map ID: 23109N Zoning: AG-1 Count
Use Type: 6000 Jurisdiction: Saint Lucie
County
Ownership
Tindall Holdings 11 LLC 1
201 Campbell RD
Fort Pierce34, L 34945
W�`�,5 OC4 5
Current Values �Q
Just/Market: $465,224 Assessed:
Exemptions: $0 Taxable:
Date
08-31-2016
04.26-20 t 6
12-20-2002
View:
Year Built. 2019
Primary Wall: Wood/Sheath
Bedrooms: 0
Full Baths: 0
Half Baths: 0
Legal Description
9 35 39 E 112 OF NW 1/4-LESS RD R/W AS IN PS 22-16 AND
LESS THAT PART MPDAF: BEG N 1 /4 COR OF SEC, TH S 00
33 01 E 40 FT, TH N 74 59 29 W 155.70 FT TO N LI OF SEC,
TH S 89 52 38 E ALG N LI 150 FT TO POB- (82.63 AC -
3,599,363 SF) (OR 3862-2900; 3919-2630)
$91,323 Year
$91,323 2020
2019
2018
Historical Values 3-year
JusUMarket
Assessed
Exemptions
Taxable
$465,224
$91,323
$0
$91,323
$396,624
S22,723
$0
$22,723
S396,960
$22,743
$0
$22,743
Sale History
Book/Page
Sale Code Deed Grantor
Price
3919 / 2630
0130 WD Environmental Land Development
$255,800
Inc
3862 / 2900
0001 WD AA Roach Investment Ldt Part
$350,000
1680 / 1025
YX04 WD AA Roach Mgt Corp
$3,300
Primary Building Information
Finished Area of this building: 0 SF
Gross Sketched Area: 3,240 SF
Roof Cover: Sheet Metal
Frame:
Story Height: 1 Story
A/C %: N/A°/
Heated %: N/A%
Sprinkled %: N/A%
Exterior Data
Roof Structure: Gable
Grade: FamtUTA
No. Units: N/AN/A
Interior Data
Electric:
Heat Type:
Heat Fuel:
Total Areas
Building Type: FarmUtil
Effective Year: 2019
Secondary Wall:
Primary Int Wall:
Avg Hgt/Floor: 0
Primary Floors:
Finished/Under Air
0
(SF):
Gross Sketched Area
5,304
(SF):
Land Size (acres):
82.63
Land Size (SF):
3,599,363
Total Building Count:
3
Special Features and Yard Items
Type Qty Units Year Bit
All information is believed to be correct at this time, but is subject to change and is provided without any warranty.
0 Copyright 2020 Saint Lucie County Property Appraiser. ALI rights reserved.
St. Lucie County Health Department
�uL= 5150 NW Milner Dr Port Saint Lucie, FL 34983
HEALTH
PAYING ON: n: BILL Doca:56-BID-5153082
RECEIVED FROM: James Paul Tyson 11352 AMOUNT PAID: $ 115.00
PAYMENT FORM: CREDIT CARD 015702 PAYMENT DATE: 01/14/2021
MAIL TO: James Paul Tyson 11352
Port Saint Lucie FL 34988
FACILITY NAME: James Paul Tyson 11352
PROPERTY LOCATION:
Port Saint Lucie FL 34988
Lot:
Property ID: _
-1 - Well Construction
EXPLANATION or DESCRIPTION:
1
QUANTITY FEE
$ 115.00
RECEIVED BY: AdamsC AUDIT CONTROL NO. 56-PID-4857196
Note: 59-31414 TBD Tindall Way/ 11652 Orange Ave
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