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Home My WebLink AboutAPPROVED Well & Septic HD Permit - 7704 pacific aveSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: APPLICANT: (434 21st Street OSTDS New PROPERTY ADDRESS: 7704 Pacific Ave Fort Pierce, FL 34951 LOT: 12 BLOCK: 44 SUBDIVISION: Lakewood Park PROPERTY ID #: 1301-605-0109-000-8 PERMIT #:56-SF-2240283 APPLICATION # : AP 1629786 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1523804 [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 [ 900 ] GALLONS / GPD Seotic new CAPACITY A [ ] GALLONS / GPD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 500 ] 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: Site BM, NiD CL of Rd, center of property I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L DE O T H E R [ 3.00 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT [ 4.00 ] [ INCHES FT I( ABOVE BELOW ]BENCHMARK/REFERENCE POINT ILL REQUIRED: rZS.UU] INCHES EXCAVATION REQUIRED: [ ] INCHES The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300 gpd. SPECIFICATIONS BY: Brian J I ram TITLE: Environmental Specialist III APPROVED BY: TITLE: Environmental Specialist III St. Lucie Brian J ngram DATE ISSUED: 03/29/2021 EXPIRATION DATE: DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC 09/29/2022 CHD Page 1 of 3 v 1.1.4 AP1629786 SE1488598 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. lir STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT, JD �_— �`� U�(� � _ .._.. REPAIR, 11,10DIFY, OR ABANDON A WELL F'urrit 59-31524 ,(k, _ :151�!t'1WC:i! _,L'c•'i$�iILL : t,' Florida Un::we ru— '. _... .. _.._ _... ..-........__._.,.. ,:' LiCABLE FIELDS — - - : Nprthtvr5t t'Denot(as ,',-.,.;;r,. c i i �i" V•lhera :' ,� �;i,;;,hl,, �rrrn - __ ...._._._�....... ll 9:I uL I:Wn:- r�(?Ua11Pd i84:1, 'llcY,wai �St .four:•, I A. S! %'v3It !e lbvft r - .. - '•" rim 5:� U(.(i0 Y{p, L'.1Ciitrrr.;tq;r'd:, '. tXtill;Np! F it ('rim ratin''7 r 'fifl(f'F.S •' �J .. _ ':;•: . f '+ (� ( t: ?ram c NumGr.. 1r!; ot t...t. L' ( ! !t ?LrnR:nlCt:• ^;wr t , Y! U;a, `._. .. !J_ ` t bcf.)'n;.lur� � _} } {check d G2•�2=rt� 't'es I 1 t Y lM1`rr �J 4 t (�rc..l`• 1 +\_i �ti ? ��4. t t� {..,\ - t._.7 �t . `, ( t� L� � �..�., t=fir':.i� f. - �•-�C ` �7 �±��. � .� L� : .. _ o JL - ` Crty is <,U7rtj :oral:'JX q, 1-....._ ... ----.. 7_!P r f f i.Ar;dsCupe I;ngaiiCtn _•__tir�rtctattttal krir�;,lior, _ _ Sitr. Wontip Invr:•sG�talion u� �,x+n y RaC er,fianlarrr. (rncic:Gvr. Lroe3trark t• u;,sc;ry Irr;gatiwi Tpst t 1r ltr ti(7n C:crrrmur.,{yl[:)4=='t C')rntnrrcr:rU! ttG, Earm-Coup.ed t. w4f1P.r(wil MAR 2 9 202 i --_Gall Course Irrluatto.; I IL%AC Supply ' ..... ,... ._.. .._ rHVAC Return Ls<tI S! j f.,f .J.J. .I :+� 1.1 •� `" r "�'' ��( '• � DOH in St Lucie Coo: LVIRWNMENTAL HEP t. i..t%`n '( art:, �. Yf. ,•}:.nl': .raft' c. a n ) Pttmaty i,di inc, G,Jr,,s cl � r r-lulo. flair, To S t :; tr P _.... r •,•,uri.tt F�rd� r:;t ttrjftat-t by Al�j,tu.r�,t s, r , 1 Rolivy ;., :,tar(tC r f' n•,-,ry. S%�orxirn'y. an ; .. -': ,, ... _.. _ .___ _.. . To _ 6,� i dra!r•'tit@ ,,a rats s er .`•' "V.aft r'fv^j, . 1 r tf )ar SEi1CJ,`tt,: Cement- Other_ ... . Be:u<;rnte v:_;aI Camera - OtPer, . -. . SI' Ltst r)urr,Ut:r ,:I •r; r e+ c.x):. •n.f uru> t 'netla .irt site , Ff on t}tfr Op h f'<i �Urt t;r�uQU3 Orclp At?y cUvQ.req (1rt(f$rr1 co iln imptive1water Use Pemtli (CVr1,v1: If, 1 Yt, fl yes no , titN fC!Iglaii:q GUP/NUP Vt) District Weil If) No. _._.......... _.. a;tEr) c"five VUGS $d i 1 I t r: ':C. Ji l,rI,r. r r r t'•n: t...r . t )jJ PQ . c�.!.,;77?�<�a�'�XY.ra'd(�:.".'r!14..B'^!.c'z�,a'.,.:n'-"k;.••!�1+••„'2+.,ytaa��twasxr,.orn�..s=r.... �, :.» �.� � _- _ -_- - _ 'U:IIC "` ' �F(',:ii )iE F ;ESkt•t7r\T"; Q7 !- i HE kh.'AD or\ r)ht ELATED AU T H*014, i+ u...o......,.- r� .':, %•ll_;. - E t. I ur l r',(, .:(.'..,_; ,,�•.. tit.:�•; HE:PAtR �.i;J;,):Y(CAr'�U�J, GKABAr,GG!•1htEN1 ACTNITIES 0 TH St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie FL 34983 PAYING ON: #.56-SF-2240283 BILL DOC #:56-BID-5180804 CONSTRUCTION APPLICATION #: AP1629786 RECEIVED FROM: Pedro Quiiada AMOUNT PAID: $ 660.00 PAYMENT FORM: CREDIT CARD 05845J PAYMENT DATE: 02/11/2021 MA I L TO: (434 21 st Street LLC) FACILITY NAME: PROPERTY LOCATION: 7704 Pacific Ave Fort Pierce, FL 34951 12 44 Lot: Block: Property ID: 1301-605-0109-000-8 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 -1 - Well Construction 1 $ 115.00 RECEIVED BY: WhighamJL AUDIT CONTROL NO. 56-PID-4884245 Note: 59-31524 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: PERMIT NO. �3' DATE PAID: FEE PAID: ( A(p . cro RECEIPT #: [V/] New System [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ I APPLICANT: 434 21ST STREET LLC AGENT: Pedro Quijada TELEPHONE: 954-850-0618 MAILING ADDRESS: 9111 E Bay Harbor Dr 6f, Miami FL 33154 TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST HE 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 (NM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. PROPERTY INFORMATION LOT: 12 BLOCK: 44 SUBDIVISION: LAKEWOOD PARK -UNIT 5 PLATTED: PROPERTY ID # : 1301-605-0109-000-8 ZONING: RS4 I/M OR EQUIVALENT: !, ] a PROPERTY SIZE: 027 ACRES WATER SUPPLY: [,(] PRIVATE PUBLIC [ ]<-2000GPD [ ]>2000GPD IS SEWER AVAILASI.E AS PER 381.0065, FS? [ }�e��D DISTANCE TO SEWER: FT PROPERTY ADDRESS: 7704 PACIFIC AVE, Fort Pierce FL 34951 DIRECTIONS TO PROPERTY: See attached lot location. BUILDING INFORMATION [,/] RESIDENTIAL [ ] COMMERCIAL Unit Type of No. of Building Commercial/Institutional System Design No Establishment Bedrocros Area Safi Table 1, Chapter 64E-6, PAC 1 Single -Family 3 2264 N/A 2 /��Y IR 3 4 [ ] Floor/Equipment Drains [ J Other (Specify) SIGNATURE: t DATE: DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC Page 1 of 4 AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE BENCHMARK/REFERENCE POINT LOCATION ELEVATION OF PROPOSED SYSTEM SITE STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: 434 21 st Street LLC CONTRACTOR / AGENT: Pedro Quijada LOT: 12 BLOCK: 44 APPLICATION # AP1629786 PERMIT # 56-SF-2240283 DOCUMENT # SF-1488598 SUBDIVISION: Lakewood Park ID#: 1301-605-0109-000-8 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: TOTAL ESTIMATED SEWAGE FLOW: 300 404.99 750.00 [X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.27 ACRES GALLONS PER DAY [ RESIDENCES -TABLET/ OTHER -TABLE 2 ] GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT Site BM, NiD CL of Rd, center of property 3.00 [ INCHES / FT ] [ ABOVE / ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES/SWALES: 15 FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 75 FT NON -POTABLE: 87 FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 55 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 SOIL PROFILE TNFORMATTON STTE 1 SOTL PROFTLF. TNFORMATTON STTF. 2 USDA SOIL SERIES: Munsell #/Color Texture Depth 10YR 4/1 Sand 0 To 10 10YR 5/1 Sand 10 To 24 10YR 6/1 Sand 20 To 25 10YR 411 Loamy Sand 25 To 28 10YR 4/1 Sand 28 To 39 10YR 5/1 Sand 39 To 57 10YR 5/3 Sand 57 To 65 HOLE CAVING Refusal 65 To 72 USDA SOIL SERIES: Munsell #/Color Texture Depth 10YR 4/1 Sand 0 To 15 10YR 5/1 Sand 15 To 32 10YR 6/1 Sand 17 To 33 1OYR 4/2 Loamy Sand 33 To 37 10YR 5/2 Sand 37 To 52 10YR 5/3 Sand 52 To 63 HOLE CAVING Refusal 63 To 72 OBSERVED WATER TABLE: 40.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 17 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 17 nn INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Loamy Sand/0.60 DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: [ ] TRENCH [XI BED [ ] OTHER (SPECIFY) FREMARKS/ADDITIONAL CRITERIA WSWT determined using USDA WSS and soil borings. 10YR6/1 stripping in 10YR5/1 matrix >10% with diffuse boundaries starting at 17" in SB2. SB1 and SB2 3" below BM. SITE EVALUATED BY: Ingram, Briaif (Title: Environmental Specialist III) (ENVIRONMENTAL HEALTH) DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC INCHES DATE: 03/08/2021 Page 3 of 4 AP1629786 EID2240283 v 1.0.2 aAiS 30N31d IMOJ • ir LL Q)