HomeMy WebLinkAbout5110 palmetto dr faSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: Synergy Homes, LLC
AGENT: DEANNE JOHNSON
PROPERTY ADDRESS: 5110 Palmetto Dr Fort Pierce, FL 34982
LOT: 5 & 6
BLOCK: 24
APPLICATION #:AP1581698
PERMIT # : 56-S F-2171708
DOCUMENT #.F11680664
DATE PAID - 09/30/2020
FEE PAID:545.00
RECEIPT # :56-PI D-4698136
SUBDIVISION: Indian River Estates ID#: 3402-606-0073-000-5
CHECKED [XI ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
[01] TANK SIZE [11 1090.00 [21
[ 02 ] TANK MATERIAL Polypropylene
[031 OUTLET DEVICE
[041 MULTI -CHAMBERED [ LIJ N ]
[051 OUTLET FILTER Polylok PL-68
[061 LEGEND 1. 70-143-11 DC4
[071 WATERTIGHT
[081 LEVEL
[091 DEPTH TO LID
DRAINFIELD INSTALLATION
[101 AREA [1] 675 [2;
[111 DISTRIBUTION BOX
[121 NUMBER OF DRAINLINES
[131 DRAINLINE SEPARATION
[141 DRAINLINE SLOPE
[151 DEPTH OF COVER
[161 ELEVATION [ ABOVE /
[171 SYSTEM LOCATION
[181 DOSING PUMPS
[191 AGGREGATE SIZE
[201 AGGREGATE EXCESSIVE FINE
[211 AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
[ ] [221 FILL AMOUNT
[ ] [231 FILL TEXTURE
[ ] [241 EXCAVATION DEPTH
[ ] [251 AREA REPLACED
[ 1 [261 REPLACEMENT MATERIAL
Comments: Comments are on Pac7e 2.
2.
SQFT
HEADER X
1. 9.00 2.
BELOW IBM 6.00
CONSTRUCTION [ APPROVED / DISAPPROVED ]:
SETBACKS
[ ] [271
SURFACE WATER
FT
[ ] [281
DITCHES 49
FT
[ ) [291
PRIVATE WELLS 100
FT
[ ] [30)
PUBLIC WELLS
FT
[ ] [311
IRRIGATION WELLS
FT
[ ] [321
POTABLE WATER 45
FT
[ ] [331
BUILDING FOUNDATIONS 11
FT
[ ] [341
PROPERTY LINES 22
FT
[ ] [351
OTHER
FT
FILLED / MOUND SYSTEM
[ ] [361
DRAINFIELD COVER
[ ] [371
SHOULDERS
[ 1 [381
SLOPES
[ ] (391
STABILIZATION 08/12/2021
ADDITIONAL INFORMATION
[ ] [401
UNOBSTRUCTED AREA
[ ] [411
STORMWATER RUNOFF
[ ) [421
ALARMS
[ ] [431
MAINTENANCE AGREEMENT
[ ] [441
BUILDING AREA
[ 1 [451
LOCATION CONFORMS WITH SITE PLAN
[ ] [461
FINAL SITE GRADING
[ ] [471
CONTRACTOR Mitchell Mark White (Southea
[ ] [481
OTHER INFILTRATOR ARC 24
ABANDONMENT
[ ] [49)
TANK PUMPED
[ ] [501
TANK CRUSHED & FILLED
St. Lucie CHD
n J Ingram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM [ APPROVED / DISAPPROVED ]: 7 St. Lucie cHD
Envifonmental Special is Brian J Ingram (ENVIRONMENTAL HEALTH)
(Explanation of Violations on following page)
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
EH Database v 1.0.1 AP1501698 EID2171708
DATE: 06/16/2021
DATE: 08/12/2021
Page 2 of 3
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
Comments
APPLICATION #:AP1581698
PERMIT #:56-SF-2171708
DOCUMENT #: F11680664
DATE PAID..09/30/2020
FEE PAID:545.00
RECEIPT #:56-PID-4698136
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 400
gpd.
New ST, filter, and 9x5 long BED DF installed. No violations, system ok to cover, contractor notified by phone. Needs final
nspection for mound system and final site grading.
final system approved. Contractor and building department emailed final approval.
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database v 1.0.1 AP1581698 EID2171708