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HomeMy WebLinkAboutSewageSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Charlotte Almore PROPERTY ADDRESS: 20025 Southern Star SE wing Fort Pierce, FL 34945 LOT: 7 PROPERTY ID #: BLOCK: 2215-700-0009-000-8 SUBDIVISION: PERMIT #: 66-SF-1806243 APPLICATION #: AP1317612 DATE PAID: FEE PAID: RECEIPT #• DOCUMENT #: PR1084712 [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 Septic 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 [ 375 ] SQUARE FEET Drainfield. new SYSTEM R [ ] SQUARE FEET N/A SYSTEM ' A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [x] MOUND [ ] I -CONFIGURATION: [X] TRENCH [ ] BED [ ] N F .LOCATION OF BENCHMARK: BM West of turnabout @ CL of Rd by NE property corner I ELEVATION OF PROPOSED SYSTEM SITE [ 0.00 ][ INCHES FT ][ ABOVE BELOW] BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 16.00][ INCHES FT ][ ABOVE BELOW] BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [34.001 INCHES EXCAVATION REQUIRED: [ 65.001 INCHES O T H E R 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. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E-6.013(3)(f), FAC. SPECIFICATIONS BY: Brian Davis APPROVED BY: TITLE: rian J Ingram TITLE: Master Septic Tank Contractor t DATE ISSUED: 12/06/2017 AE DH 4Q16,.09/09 (Obsoletes all previous editions which may not be used) incorporated: 64E-6.003, FAC V 1.1.4 AP1317612 SE1055975 St. Lucie CHD 19 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 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 5150 NW Milner Dr Port Saint Lucie, FL 34983 PAYING ON: PERMIT#:56-SF-1806243 BILL DOC#.56-BID-3636474 CONSTRUCTION APPLICATION* AP1 317612 RECEIVED FROM: Kamer Survevinq. Inc AMOUNT PAID: . $ 400.00 PAYMENT FORM: CREDIT CARD PAYMENT DATE: 12/01/2017 MAIL TO: Charlotte Almore FACILITY NAME: _ PROPERTY LOCATION: 20005 Southem Star House 2 Fort Pierce, FL 34945 Lot: 7 Block: Property ID: 2215-700-0009-000-8 EXPLANATION or DESCRIPTION: QUANTITY FEE 128 - OSTDS Construction System Inspection Research Fee 1 $ 5.00 -1 - Surcharge (All) 1 $ 15.00 -1 - OSTDS New Permit Surcharge 1 $ 100.00 -1 - OSTDS Construction Application and Plan Review,New 1 $ 100.00 126 - 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: VanceMH AUDIT CONTROL NO. 56-PID-3445463 STATE OF FLORIDA PERMIT NO. DEPARTMENT OF HEALTH DATE PAID s ONSITE $SWAGE TREATMENT AND DISPOSAL FRS PAID: SYSTEM RBCSIPT #: APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [� ] New system [ 3 Existing system [ 3 Holding Tank I ] Innovative [ ] Repair [ i Abandonment [ 1 Temporary I ] "PLICANTs Charlotte Almore AGENTS KAANBR SURVEYING INC TZtZPH0N$(772) 288 7206 HAILING ADDRESSs 2740 SW MARTIN DOWNS BLVD #333, PALM CITY, FL. 34990 seasssrsrsnrrrrrmamrrrrsrrsumrArsrsrrrrrsssrrrr.rrrnrrrrsrrrrrarmra�rr rrsssr srrrmsmsAmasmaa TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTWO MUST BE CONSTRUCTED SY A PERSON LICENSED PURSUANT TO 469.105(3)(m) OR 489.552, FLORIDA STATGTBS. IT T8 T88 APPLICANT'S 7t1l9PONSIBiLITY TO PROVIDE DOCUMENTATION OF T= DATE THS LOT WAS CREATED OR FLATTED '(Mf/DD/YY) 17 REQUESTING CONStDBRATION OF STATUTORY GRANDFATHER PROVISIONS, sunssssrarsrwrasrrsrss��rMarsrrsrrrrrsrsrsrsrreraaasatarrrsrrsrrrrsrssrrr ssrrttrnr..rssrsxasssr PROPERTY INFORMATION LOT: I BLOCRs N/A SUBDIVISIONS Southern Star stables PLATTSDs 6/2006 PROPERTY ID #: 2215:700-0009-000-8 ZONiNO: A— I/N OR EQUIVALwT: I T / PROPERTY SIZSs 10.96 ACRES WATER SUPPLYS 4—PRIVATE PUBLIC I 3<r20000PD I 1>20000PD DISTANCE TO SVWHR: FT� IS SEWER AVAILABLEggg AS PER 361.0065, [ Y /09 PROPERTY ADDRESSs Southern Star Drive, Sort Pierce, V1. 34945 DIRECTIONS TO PROPERTYs Ahar .- nrooesty is at t t ft BUX=j 4 ZHVORMATtON I �RESIDZMXAL I I COI6M8RCIAL Unit TWO of No. of Building Co=eroial/IAetitutiOPal System Design NO Hatablisbaent Beyo Area Sgft Table 1, CSi�64E-6, PAC RESIDENCE K 2 3 4 I 3 Floot/Equipmnent Drains I ] Other (Specify) of SIGNATURE= DATE: Di; 4015, 10/97 (previous 8diticas X4y Be Used) ONLINE VSRSION Page 1 of 4 Hcx,(,;,� 4 7Z, STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITT SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS PERMIT # - 5� - SF ' t D D (PZ FPLICANT: Charlotte Almore AGENT: KARNER SURVEYING INC AT: 7 BLOCC: N/A sUBDIViszom Southern Stag Stables ROPERTY ID #:2215-700-0009-000-8 [Section/Township/Parcel No. or Tax ID Number] 0 BE COMPLETED BY ENGINEER, HEALTH D3PARTWMNT.3MPL0Y3E,OR OTHER QUALIFIED PERSON, BNGINNSERS UST PROVIDE REGISTRATION NUMBRR AND SIGN AND -ORAL BACH PAGE OF SUBMITTAL. COMPLETE ALL ITMRMS. ROPNRTY SIZE CONFORMS TO SITE PLAN: 1* YES [ ] ISO NET USABLE AREA AVAILASL$i10. 96 A/C` ACRES OTAL• ESTIMATED SEWAGE FLOAT:GALLONS PER DAY 8NC88-TASL /OTHER-TASLEZj �G> ;UTHORIZED SEWAGE FLOAT: w GALLONS PER DAY 2500 GPD/ACRE] NOBSTRUCTED AREA AVAILABL28 _ > SQFT UNOBSTRUCTED AREA RZOUT 21500 SQFT ENOHMABK/mFERENCB POINT LOCATION: LEVATION OF PROPOSED SYSTEM SITE IS [==S/rf1- [ mmmr BENCHMAI7R/itES$RENCE POINT -HE MINnM(kM SETBACK WHICH CAN BE MAINTAINED FROM THE PVVOSED SYSTZM TO THE FOLLOWING FEA S !URFACE WATER: /2V- O�`T DITCHES/ S:— --(I1 8'T NORMALLY WET4 [ ] YESrknNO ZTj-L9.: PUBLIC :�� TT LIMITED USE: FT PRIVATE : —%FT NON-POTADS.E :4LET FT BUILDING FOUNDA 1 Q FT BROPERTY LINES: 1l�_'IT POTABLE WATER LINES:�„' tITZ SUBJECT TO FREQUENT FLOODING: [ ] S V] NO 10 YEAR FLOODING? /( ] YES ji(] NO .0 YEAR FLOOD ELEVATION FOR SITE: FT M5L/NGVD SITE ELEVATION: Ct" FT XSL/NGVD :TEXTURE DER7 rJ TO TO S 0�p 51.E -fir-' To TO TO USDA SOIL SERIES iwsELL # COLOR TEXTS D�Yrn v t ci ep r( TO( 6 To �3 ---- TO . O TO TO TO USDA SOIL SERIES 51 �y 21 INCHES LABOVE / j EXISTING G1iADE . TYPE: ERCHED msmvgn WATER TABLE: / GRADE ESTIMATED NET WATER TABLE RLEVATION:� INCHES LABOVE / ] EXISTIma NG GGRADE 910i WATER TABLE VEGETATION: [ I YES V% NO TNG: ,[�] YES [ NO DEPTH: _INCHES AICD SIZING:. DEPTH OS ERCAVSTION: � MCI= SOIL TEXTURE/LOADING RATE 1 SYSTEM ,ram (S DMiAINSIELD CONBxGiJRATION: (] 'FRENCH L ] C� ] 9 tics/ADDI.TIor1AL CRITERIA:SY� - . f�f o r SITE MSVALUATED BY: 939 40.15,. 66/0.0 (Qbscistes previous sditions which may not be used) incorporated: 64E-8.001, FAC Page 3 of 4 )roperty Card Page 1 of 6 5(o-Sr- - IYO(0243 Michelle Franklin, CFA -- Saint Lucie County Property Appraiser — All rights reserved. Property Identification Site Address: TBD Parcel ID: 2215-700-0009- Account #: 168610 Sec/Town/Range: 000-8 15/35S/38E Map ID: 22/15X Zoning: Use Type: 0000 Jurisdiction: Saint Lucie County Ownership Legal Description Charlotte Almore SOUTHERN STAR STABLES S/D (PB 53-24) LOT 7 (10.95 Bertrand Laidler Jr AC) (OR 3986-1904; 4029-1582) Michael E Bell II 1200 Tumblin Kling RD Fort Pierce, FL 34982-6952 Current Values Historical Values 3-year Just/Market: $98,600 Assessed: $98,600 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $98,600 2017 $98,600 $98,600 $0 $98,600 2016 $109,500 $98,360 $0 $98,360 2015 $108,800 $89,419 $0 $89,419 Sale History Date Book/Page Sale Code Deed Grantor Price 06-19-2017 4029 / 1582 0111 QC Almore Charlotte $100 04-18-2017 3986 / 1904 0001 WD Rynard John D $119,000 03-05-2012 3368 / 0745 0202 WD Steele,Tracy D $330,000 Primary Building Information Finished Area of this building: 0 SF Gross Area of this building: 0 SF Exterior Data View: Year Built: N/A Primary Wall: Bedrooms: 0 Full Baths: 0 Half Baths: 0 Type Roof Cover: Roof Structure: Frame: Grade: Story Height: No. Units: 0 Interior Data A/C %: 0% Electric: Heated %: N/A% Heat Type: Sprinkled %: 0% Heat Fuel: !,aloge Total Areas Building Type: Effective Year: 2014 Secondary Wall: Primary Int Wall: Avg Hgt/Floor: 0 Primary Floors: (.g Finished/Under Air 0 Sketch (SF): tii' available Gross Area (SF): 0 for r7`1*5pIc7}, Land Size (acres): 10.95 Land Size (SF): 476,982 Total Building Count: 1 Special Features and Yard Items Qty Units Year Blt This information is believed to be correct at this time but it is subject to charge and is not warranted. - © Copyright 2017 Saint Lucie County Property Appraiser. All rights reserved. ttD://www.r)asic.ora/RECard/ N S� ALMORE RESIDENCE a f o 20005 SOUTHERN STAR DRIVE r !III P 5 FORT PIERCE, FLORIDA gj.. C o. 3 FLOOR PLAN Pi STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Charlotte Almore PROPERTY ADDRESS: LOT: 7 PROPERTY ID #: PERMIT #: 56-SF-1806241 APPLICATION #- AP 1317611 DATE PAID• FEE PAID: RECEIPT #: DOCUMENT #: PR1084676 20025 Southern Star Dr. Main house and NW wing Fort Pierce, FL 34945 BLOCK: SUBDIVISION: 2215-700-0009-000-8 [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 [ 1,650 ] GALLONS / GPD Septic new CAPACITY A [ ] GALLONS / GPD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] dALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ D [ 875 ] SQUARE FEET Drainfield new SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [x] MOUND [ ] I CONFIGURATION: [x] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: BM west of turnabout @ CL of Rd by NE property corner I ELEVATION OF PROPOSED SYSTEM SITE [ 0.00 ][ INCHES FT I ABOVE BELOW] BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 16.001[ INCHES FT ][ AHOVE BELOW] BENCHMARK/REFERENCE POINT L D FILL REQUIRED:. [34.001 INCHES EXCAVATION REQUIRED: [ 65.001 INCHES O T H E R The system is sized for 7 bedrooms with a maximum occupancy of 14 persons (2 per bedroom), for a total estimated flow of 700 gpd. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E-6.013(3)(f), FAC. SPECIFICATIONS BY: Brian Davis TITLE: Master Septic Tank Contractor APPROVED BY: TITLE: Environmental Specialist II St. Lucie CHD rian J Iram DATE ISSUED: 12/06/2017 EXPIRATION DATE DH 4016, 08/09 (Obsoletes all previous editions which may #IneV Incorporated: 64E-6.003, FAC ko v 1.1..4 MP1317611 SE1055948 06/06/2019 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 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 5150 NW Milner Dr Port Saint Lucie, FL 34983 PAYING ON: PERMIT*56-SF-1806241 BILL DOC#•56-BID-3636470 CONSTRUCTION APPLICATION t AP1317611 RECEIVED FROM: Kamer Survevinci, Inc AMOUNT PAID: $ 400.00 PAYMENT FORM: CREDIT CARD PAYMENT DATE: 12/01/2017 MAIL TO: Charlotte Almore FACILITY NAME: PROPERTY LOCATION: 20005 Southern Star Main House Dr Fort Pierce, FL 34945 Lot: 7 Block: Property ID: 2215-700-0009-000-8 EXPLANATION or DESCRIPTION: QUANTITY FEE 128 - OSTDS Construction System Inspection Research Fee 1 $ 5.00 -1 - Surcharge (All) 1 $ 15.00 -1 - OSTDS New Permit Surcharge 1 $ 100.00 -1 - OSTDS Construction Application and Plan Review,New 1 $ 100.00 126 - 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: VanceMH AUDIT CONTROL NO. 56-PID-3446459 5f-5F-7dYO(2.'JJ Todd N. Smith, PE, Inc. 914 20'` Place Vero Beach, Fl. 329560 772-559-3699 tnspe@bellsouth.net November 29, 2017 Brian Ingram St. Lucie County Environmental Health Services 5150 NW Milner Dr. Port St. Lucie, F134983 RE: 20005 Southern Star Dr., Ft. Pierce Dear Mr. Ingram: It is my understanding that the 3 houses on the referenced property is being considered by the Health Dept. as one combined area. The contractor proposes to split the lot flows for each respective house. Whereby, the flows would be 300 gpd for each 3 bedroom house < 2250 sq living area and 400 gpd for the 4 bedroom house < 3300 sq ft living area as per 64E6. We have no objection to this type of analysis and find that it complies with the requirements of 64E-6. Additionally, combining the flow for the main house and house #2 will be 700 gpd and the stand alone flow for house #1 will be 300 gpd. Therefore, one septic system shall serve the main house and house #2 and the other system would be designed to serve the stand alone house #3. Please call me if you have any questions. Sincerely, ♦����,�N SMl �� i ♦ � ice' 2 • 0. r w • w 0 Z •�C : P•('E ; yr Todd N. Smith%P , s� Fl. Engineer's I F �6 •'��G�,.` �•,, ssioNP �,. irii111�` CC: Brian Davis - Brian Davis Septic & Backhoes Services, Inc. STATE OF FLORIDA PERMIT NO. SF i�0 DEPARTMENT OF HEALTH DATE PAID s ONSIT,E SEWAGE TREATMENT AND DISPOSAL FEE PAID: SYSTEM RECEIPT # s APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: (4 ] NOW System ( 1 Existing System [ ] Holding Tank [ ] Innovative ( ] Repair ( ] Abandonment ( ] Temporary ( I APPLiCAms Charlotte Almore AGENTS KnNER SURVEYING TNC TELEPHONS(772) 288 7206 MA*LZRG ADDRESS:.2740 SW MARTIN DOWNS BLVD #333, PALM CITY, FL. 34990 assssassssssassssassssrasssaasssssass;;iaaaca:rsaasasssaossssaosassssas�,rcasaa■s,oaossaasao TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGBM' SYSTEMS MUST -BE CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489.105 0)(m) OR 499.552, FLORIDA STATUTES. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE DOCUMENTATION OF THE DATE TRS LOT WAS CREATED OR PLATTED (MEd/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. sso=woonsiWsoNow snosswsaino0"MsassMali oamoaa;assas=asoaaaaaasassssasoosa®ssossasssssmown Ninon PROPERTY INFORMATION LOTS 7 BLOCK: N/A SUBDIVISION: Southern Star Stables PLATTED: 6/2006 PROPERTY ID #: 2215-700-0009-000-$ SONINOs I/M OR SQUIVALEMT: I Y / PROPERTY SIZE: 10.96 ACRES WATER SUPPLY; (X] PRIVATE PUBLIC ( 3<a2000GiPD ( ]>2000GPD IS tMOR AVAILABLE AS PER 381.0065, FS? [ Y 41 DISTANCE TO SEWER: PROPERTY ADDRESS: Southern Star Drive. Fort Pierce, Fl. 34945 DIRECTIONS TO PROPERTY: Orange Ave West eF..Y - nronerty is at the intersect on BUILDWO INFORMATION Unit Type Of No . Establishment IY4_ RESIDENTIAL No. o£ Bedrooms 1 RBSIDENCE AkA1''y t6`t_ 2 14e, U 4L-z� r 4 Left on Soutn+ [ ] COMMERCIAL Building Commercial/ItstitutiOnal System Design Area Sqft Table 11 Chapter 648-6, PAC _ 750 q zz3 7cw 9 / /9 /r-Vc u ( j Floor/Equipment Drains I ] Other (specify) STONATDRB s--�'�" f DATE: G DR 4015, 10/97 (Previous Editions Nay Be Used) ONLINE VERSION Page 1 of 4 A'1d HoB 1 ' STATE OF FLORIDA PERMIT #. �(9 �d��^ I k� Z�1 DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS PPLI•CANT: Charlotte Almore_ AGENT: KARNER SURVEYING INC ATs 7 BLOCRs N/A SUBDIVZSIONs Southern Star Stables ROPERTY ID #:2215-700-0009-000-8 [Section/Tomahip/Parcel No. or Tax ID Number] 0 BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINNSSRS UST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. P-)/ ROPERTY SIZE CONFORMS TO SITE PLANS I+13 YES [ NO NET USABLE ' LE:10.95 A/C ACR88 OTAL ESTIMATED SEWAGE BLOWS CP GALLONS PER DAY RS IiCBS.-TABL _/OTHER-TABLE23 � tRG .UTSORtZED SEWAGE FLOW: / 7 Grp GALLONS PER DAY -PD' . Olt 2500 GPD/ACRE] NOBSTRUCTED AREA AVAILABLE[ SQFT UNOBSTRUCTED AREA REQUIREDSQFT Lo ENCHMARiC/REFERENCE POINT LOCATION:/3/�l Ae7te) r' wA LEVATION OF PROPOSED SYSTEM SITE Ij--Z= CISCHE BELOW3 BENCHMARKI'REFER3iNCE POINT 13. MINiM[7M SETBACK WHICH'CAN BE MAINTAINED FROM THE ��0POSED SYSTEM TO THE FOLLOWING FEATURES .URB'AC& WATER:. JO FT DITCHES/ .... S : ./ V�'t'-� 8'T NORMALLY WET? I 3 YES {14 NO MLLS : PUBLIC: 8'F LIMITED USE : �8'T PRIVATE :._...L�-FT NON -POTABLE : 4 FT ?� FT PROPERTY LINES: FT POTABLE WATER LINE$:��FT It7I7�DING FOUNDATIONS-:' / -�--. IlTE SUBJECT TO FREQUENT FLOODING: { 3 6NO .0 YEAR FLOOD ELEVATION FOR SITE: L FT MSL/NGVD TE7[TORE -s l� USDA SOIL: SERIES; TO 10 YEAR 1740DIYES 13 NO SITE ELEVATION:NG? FT MSL/NGVD. TEXTURE- +„ 5 �5 USDA SOIL SERIES-' S I G>n4y DEPTH v To TO Z TO/ 117F TO 6S G�7z TO T� TO TO OBSERVED WATER TABLE: -/��} EXISTING GRADE. TYPE: HED / ARPARE ] Z- INci;Ee {ABovE &3TIMATED WET SEASON Wmm TABLE ELEVATION:--- INCHES [ABOVE / BE EXISTING GRADE HTGH WATER TABLE VEGETATION: [ ] YES [,%j..NO TE TLING. EX -YES; -YES;{ 3 NO DEPWHs�NCH IES NG SOIL TEXTURE/LOADIRATE FOR SYSTEM SIZING: DEPTH OV ExCAVATMON; ? 11zCHR3 DRAINFIELD CONFIGURATION:. I�3 CH I l BED I 3� OTHER (88aC287L) REMARK3�f ADDITIONAL tZA: � � �ZLa AAel- SITE EVALUATED BY • f /J%- b;ALA � �7 CO2 t y l `33'�—�• D8 4615, 09/09 (Cbsoietei previous editions which may not be used) Incorporated: 64E-S.001. FAC Pago 3 of 4