HomeMy WebLinkAboutAPPROVED HEALTH DEP. SEPTIC WELL FLOOR PLAN STATE OF FLORIDA PERMIT #: 56-SF-2336327
DEPARTMENT OF HEALTH APPLICATION #: AP1700867
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM
Ur
CONSTRUCTION PERMIT FEE PAID:
RECEIPT #:
Y DOCUMENT #: PR1620862
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Denise Guettler
PROPERTY ADDRESS: 540 Pulitzer Rd Fort Pierce, FL 34945
LOT: 02 BLOCK: SUBDIVISION:
PROPERTY ID #: 2308-700-0002-000-4 [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 J GALLONS / GPD Sentic New CAPACITY
A [ J 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 J 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: Red nail bottom of Palm, E of site.
I ELEVATION OF PROPOSED SYSTEM SITE [ 19.00 ] [ INCHES FT ] [ ABOVE' BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 2.00 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [35,003 INCHES EXCAVATION REQUIRED: [ 4.00 ] INCHES
O The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow of
T 300 gpd.
H
E
R
SPECIFICATIONS BY: Jafar Yousefi TITLE: Private CEHP 19-0754
APPROVED BY. 42 / TIT"E: Environmental Specialist II St. Lucie CHD
N2.c a 2ontInez
DATE ISSUED: 08/05/2021 EXPIRATION DATE: 02/05/2023
DH 4016, 08/09 (Obsoletes all previous Oeitions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 0£ 3
v 1.1.4 AP1700867 SE1577587
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.
Ron DeSantis
Mission: Governor
To protect,promote&improve the health
of all people in Florida through integrated
state,county&community efforts. FTOYI Scott A. Rivkees,MD
HEALTHState Surgeon General
Vision:To be the Healthiest State in the Nation
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
SLC DOH-WELLS CCDFLH EALTH.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(�D,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. Lucie County Accredited Health Department
5150 NW Milner Drive•Port St.Lucie,Ft.34983 Public Health Accreditation Board
PHONE:772/462-3800•FAX:772/871-5360
StLucieCountyH eal th.com
�.." dotloop signature verification:ltili.u;liQvf•p,IJitJ•'rsly 0
- STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT,
' r REPAIR,MODIFY,OR ABANDON A WELL Permit No. 59-32358
❑Southwest PLEASE FILL OUT ALL APPLICABLE FIELDS Florida Unique ID
❑Northwest ('Denotes Required Fields Where Applicable) Permit Stipulations Required(See Attached)
=± 0St.Johns River
gre water veNcontruaarlrresponstble tot cnrnpletlnp
0South Florida
this rorrnanrlionmurlinytheperrnirapplicalivnruthe 62-524 Quad No. Delineation No.
' s C)4# '~>^`` Suwannee River nppropriutc dcicpnrcd nuthoritytvhcrenpp!icnbrc.
❑DEP CUP/WUP Application No.
❑Delegated Authority(If Applicable)
1.Denise&Gerard Guettler 540 Pulitzer Road, Fort Pierce, FL 34945
'Owner,Legal Name if Corporation "Address 'City "State ZIP Telephone Number
2.540 Pulitzer Road Fort Pierce FL 34945
'Well Location-Address,Road Name or Number,City
3.2308-700-0002-000-4 2
'Parcel ID No.(PIN)or Alternate Key(Circle One) Lot Biocl< Unit
4.08 35S 39E St Lucie D Moore's S/D Check if 62-5240 Yes❑ No
'Section or Land Grant 'Township 'Range 'County Subdivision
5,'Scott's Drilling, Inc. _ 11213 772-216-3525 ScottsDrilling@Bellsouth.net
'Water Well Contractor 'License Number 'Telephone Number E-mail Address
6.5014 Palm Drive Fort Pierce FL 34982
'Water Well Contractor's Address city State ZIP
7. 'Type of Work: Q Construction ❑ Repair ❑ Modification❑ Abandonment
8. 'Number of Proposed Wells ONE Reason for Repnir, Modification,or Abandonment
9. 'Specify Intended Use(s)of Weli(s): A f3 2,020'wl;
Domestic Landscape Irrigation Agricultural Irrigation Site Investigations
Bottled Water Supply ® Recreation Area Irrigation ❑ Livestock ❑ Monitoring
❑ Public Water Supply(Limited Use/DOH) ❑ Nursery Irrigation ❑ Test 1
Public Water Supply(Community or Non-Community/DEP) __1 CommerciaVlndustrial Earth-Coupled Geothermal . f+ _ 2
® Class I Injection ❑ Golf Course Irrigation HVAC Supply V
021
LJ HVAC Return
Class V Injection:❑ Recharge ❑ CommerciaVlndustrial Disposal ❑ Aquifer Storage and Recovery❑ Drainage
Remediation:❑ Recovery Recovery[-] Air Sparge ❑ Other (oescribe)
❑ Other (ooscribo)
10'Distance from Septic System if S 200 ft. 75-F-F- 11.Facility Description 0 u ar Ome 12.Estimated Start Dale
13:',Estimated Well Depth >120 ft. 'Estimated Casing Depth 100 ft.`Primary Casing Diameter in. Open Hole: From To tt.
14.Estimated Screen Interval:From 100 To 120 it.
15.'Primary Casing Material: Black Steel Galvanized ,/ PVC Stainless Steel
Not Cased Other:
16.Secondary Casing: Telescope Casing Liner Surface Casing Diameter in.
17.Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel Other
18'Method of Construction,Repair,or Abandonment: Auger Cable Toot Jetted V Rotary Sonic
Combination(Two or More Methods) Hand Driven(Welt Point,Sand Point) Hydraulic Point(Direct Push)
Horizontal Drilling Plugged by Approved Method Other (oescribo)
19,Proposed Grouting Interval for the Primary,Secondary,and Additional Casing:
From 0 To 100 Seal Material( Bentonite y/ Neat Cement Other )
From To Seal Material( Bentonite Neat Cement Other' )
From To Seal Material( Bentonite Neat Cement Other )
From To Seal Material( Bentonite Neat Cement Other )
20.Indicate total number of existing wells on site List number of existing unused wells on site
21 `1s this well or any existing well or water withdrawal on the owner's contiguous propertyy covered under a Consumptive/Water Use Permit(CUPtWUP)
or CUP/WUP Application? Yes �/ No if yes,complete the following:CUPNVUP No. District Well ID No.
22.Latitude Longitude
23.Data Obtained From: GPS Map Survey Datum: NAD 27 NAD 83 WGS 84
I1W1cby art,that 1w,U eomNy bHhthe orr'm:k tuleo elTiika0.ludo Admuthuatise CWv.anti(hat a—to Icertify tent InmUworronr of It»(nopsdy,thrd tha infamnnlen Pro WO is accerclh,and 111V 1 act owaw of my
u5u Permit ct w1eRJ31,cehame pemu,d.,WO,has Leon or w::be o_Whc4 poor to=11-Imncelnehi of w 11 rC=.Sz:tjos uWor Chatter 373,Fl011a3$13,Wes•to makto.0+pmp0rly abatd0n It.aat;u.1 c011:11 Lc;,l I am
ennstnrdian.Ilunhe,urIy N.f ai intnntalion pcst7<d tolhts ap;lG:a:inn is aeunaln ana t:tniIw•tl nhWm theaa0 I to,ihnr nor,UILI il:ohd+malixt r-Med is aca,mle,nM INA Iha.c,n1c 10 Iho—nor of Umu
Hots ary approval fron other lnlcrol,aata••of1=1Ootan—WS.if..PPLtato.lagrw to txo.-de nv 11 wsp0n3>stis;Sata' otav, nrr coraorr,to alLrn pOr..annul of Lib R4.la or Cett.alOd AU,Imriyacec,0
_44oGou ilpatl lu tho D11141 w41w,200nyS biter cun+pklum of Ii nud,tmteJ by lh:s po-R.
abandonment
doUoopp verified
/J 2X3q_A t C_y PM EDT
(9 2x3Q-AKWC-YQVti•QSfO
'Signature of Contradict 'License No. ig a ure of Owner or A nt' JJJ�'D��atee
Approval Granle 11Blry Issua Date Expiration Date Hydrologist Approval
Fee Received $ t t +(tC� Receipt No. -)t Check No.
THIS PERMIT IS NOT VALID UNTIL PROPERLY SIGNED BY AN AU • RIZED OFFICER OR REPRESENTATIVE OF THE IMAD OR DELEGATED AUTHORITY. THE
PERMIT SHALL BE AVAILABLE AT THE WELL SITE DURING ALL CONSTRUCTION,REPAIR,MODIFICATION.OR ABANDONMENT ACTIVITIES,
DEP Form:62-532.900(1) Incorporated in 62.532.400(1),F.A.C. Effective Date:October 7.2010 Page 1 of 2
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Michelle Franklin, CFA-- Saint Lucie County Property Appraiser--All rights reserved.
Property Identification
Site Address:540 PULITZER Parcel ID:2308-700-0002- Account#: 13076 Sec/Town/Range:08/35S/39E
RD 000-4 Map ID:23108S Zoning:AG-2.5-C
Use Type: 6000 Jurisdiction:Saint Lucie
County
Ownership Legal Description
Denise L Guettler(LF EST) D MOORE'S S/D LOT 2(21.98 AC)(OR 4097-1751, 1753;4113-
Gerard F Guettler(LF EST) 2868,2870)
540 Pulitzer RD
Fort Pierce,FL 34945
Current Values Historical Values 3-year
Just/Market: $367,407 Assessed: $132,703 Year Just/Market Assessed Exemptions Taxable
Exemptions: $50,000 Taxable: $82,703 2020 $367,407 $132,703 $50,000 $82,703
2019 $336,814 $99,712 $50,000 $49,712
2018 $306,105 $98,030 $50,000 $48,030
Sale History
Date Book/Page Sale Code Deed Grantor Price
03-23-2018 4113/2870 0111 WD Guettler Denise L $0
03-23-2018 4113/2868 0111 WD Moore Denise L $0
02-12-2018 4097/1753 0130 WD Guettler Denise L $100
Primary Building Information
Finished Area of this building:2,108 SF
Gross Sketched Area:2,312 SF
Exterior Data
View: Roof Cover:Metal Roof Structure:Gable Building Type:HC-
Year Built: 1994 Frame: Grade:C- Effective Year: 1994
Primary Wall:Hardi Plank Story Height:2 Story No.Units: I Secondary Wall:
Interior Data
Bedrooms:0 A/C%: 100% Electric:MAXIMUM Primary Int Wall:
Full Baths:2 Heated%: 100% Heat Type:FrcdHotAir Avg Hgt/Floor:0
Half Baths: 1 Sprinkled%:0% Heat Fuel:ELEC Primary Floors:Carpet
A
Total Areas
Ni
Finished/Under Air 2,108
(SF):
Gross Sketched Area 2,312
(SF):
Land Size(acres): 21.98
Land Size(SF): 957,449
Total Building Count: 1
Special Features and Yard Items
Type Qty Units Year Blt
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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