HomeMy WebLinkAboutHD PERMITSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR
OSTDS New
APPLICANT: Nicolas & Misty Khoury
PROPERTY ADDRESS: 1408 Lone Pine Dr Fort Pierce, FL 34982
LOT: 09 BLOCK:
PROPERTY ID #: 3409-505-0014-000-5
SUBDIVISION: Lone Pine
PERMIT #:56-SF-2353027
APPLICATION # : AP 1715611
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT # : PR1650459
[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 ] 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 [ 767 ] 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: PAINTED NID S OF PROPERTY CL OF RD. LB7025
I ELEVATION OF PROPOSED SYSTEM SITE [ 7.00 ][ INCHES FT ][ ABOVE BELOW] BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 14.001[ INCHES FT ][ ABOVE BELOW] BENCHMARK/REFERENCE POINT
L
D E
O
T
H
E
R
ILL REQUIRED: [25.00] INCHES EXCAVATION REQUIRED: [ 1 1Nunris
The system is sized for 5 bedrooms with a maximum occupancy of 10 persons (2 per bedroom), for a total estimated flow of
460 gpd.
SPECIFICATIONS BY: Matthew S Vajanyi TITLE: Environmental Specialist I
APPROVED BY: TITLE: Environmental Specialist I
Hattffew S V
DATE ISSUED: 10/04/2021 EXPIRATION DATE:
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
SE1596915
St. Lucie CHD
04/04/2023
Page 1 of 3
v 1.1.4
AP1715611
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.
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Nicolas & Misty Khoury
CONTRACTOR / AGENT: Homecrete Homes Inc - Robert Cenk
LOT: 09 BLOCK:
SUBDIVISION: Lone Pine ID#: 3409-505-0014-000-5
APPLICATION # AP1715611
PERMIT # 56-SF-2353027
DOCUMENT # SE1596915
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: 0.42 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 460 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 1049.99 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1200.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1150.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: PAINTED NID S OF PROPERTY CL OF RD. LB7025
ELEVATION OF PROPOSED SYSTEM SITE 7.00 [ 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 [ ]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 10 FT POTABLE WATER LINES: FT
SITE SUBJECT TO FREQUENT FLOODING?
10 YEAR FLOOD ELEVATION FOR SITE:
e^YT nOe%VITT V TWVnDMn TTnM CTTr 1
[ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO]
FT [ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
1 OYR 3/2
Fill - Loamy Sand
0 To 3
10YR 5/1
Fill - Loamy Sand
3 To 9
1 OY 5/1
Fill - Loamy Sand
3 To 9
10YR 5/1
Fill - Sandy Loam
3 To 9
10YR 6/8
Fill - Loamy Sand
6 To 9
1 OYR 2/1
Sand
9 To 15
10YR 4/1
Sand
15 To 36
1 OYR 511
Sand
15 To 36
10YR 2/1
Spodic Material
36 To 44
REFUSAL
Refusal
44 To 72
nnMrm7/1Ar eTMW '7
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
10YR 3/2
Loamy Sand
0 To 3
10Y 6/1
Loamy Sand
3 To 12
10YR 5/1
Loamy Sand
6 To 12
10YR 3/1
Sand
12 To 17
1 OYR 4/1
Sand
17 To 26
10YR 5/1
Sand
17 To 37
REFUSAL
Refusal
37 To 72
OBSERVED WATER TABLE: 20.00 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 [ ]NO MOTTLING: [X]YES [ ]NO DEPTH: 17.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING
DRAINFIELD CONFIGURATION: [ ] TRENCH
7 REMARKS/ADDITIONAL CRITERIA
[ X ] BED
Sand/0.60 DEPTH OF EXCAVATION:
[ ] OTHER (SPECIFY)
3WT determined using USDA WSS and soil borings. 10YR5/1 stripping in a 10YR4/1 matrix > 10% with diffuse boundaries starting
17" in SB2. SB1 5" above BM. S132 7" above BM.
SITE EVALUATED BY:
Vajanyi, Matthew (Title: E ronme Specialist 1) (Florida Department of Health in S
DH 4015, 08/09 (Obsoletes previous editions which may be used) Incorporated: 64E-6.001, FAC
AP1715611 EID2353027
INCHES
DATE: 09/24/2021
Page 3 of 4
v 1.0.2
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
HEALTH
PAYING ON: #: 56-SF-2353027 BILL DOC #:56-BID-5546034 CONSTRUCTION APPLICATION #: AP1715611
RECEIVED FROM: Homecrete Homes Inc - Robert Cenk AMOUNT PAID: $ 545.00
PAYMENT FORM: CREDIT CARD 06394G PAYMENT DATE: 08/20/2021
MAIL TO: Nicolas & Misty Khoury
FACILITY NAME:
PROPERTY LOCATION:
1408 Lone Pine Dr
Fort Pierce, FL 34982
09
Lot:
Property ID: 3409-505-0014-000-5
EXPLANATION or DESCRIPTION:
Block:
128 - OSTDS Construction System Inspection Research Fee
-1 - Surcharge (All)
-1 - OSTDS New Permit Surcharge
-1 - OSTDS Construction Application and Plan Review,New
123 - OSTDS Construction Site Evaluation
126 - OSTDS Construction Permit (New or Mod, Amendment)
127 - OSTDS Construction System Inspection
133 - OSTDS Construction Reinspection
QUANTITY
FEE
1
$
5.00
1
$
45.00
1
$
100.00
1
$
100.00
1
$
115.00
1
$
55.00
1
$
75.00
1
$
50.00
RECEIVED BY: AdamsC AUDIT CONTROL NO. 56-PID5171484 __w
T STATE OF FLORIDA
�-q DEPARTMENT OF HEALTH
LF ONSITE SEWAGE TREATMENT AND DISPOSAL
°•;, SYSTEM
."�=�� APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
PERMIT NO.
DATE PAID :_ �-
FEE PAID: z,54
RECEIPT #: ef.L C: :-5rNL7
New System [ ] Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair [ ] Abandonment [ ] Temporary [ ]
APPLICANT: KHOURY, NICOLAS & MISTY
AGENT: HOMECRETE HOMES INC / ROBERT CENK
MAILING ADDRESS: 9773 SW SANTA MONICA DR, PALM CITY FL 34990
TELEPHONE: 772-873-6707
TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE 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 (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS.
PROPERTY INFORMATION
LOT: 9 BLOCK: SUBDIVISION: LONE PINE SUBDIVISION
PROPERTY ID # : 3409-505-0014-000-5
PROPERTY SIZE: .42 ACRES WATER SUPPLY: [
PLATTED: 12/14/20':
ZONING: PLAN th I/M OR EQQUIVALENT: [ No ]
] PRIVATE PUBLIC [j,/- 2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: 1408 LONE PINE DR, FT PIERCE FL 34982
DIRECTIONS TO PROPERTY: TAKE W MIDWAY RD TO S CITRUS AVE, TRAVEL SOUTH ON S CITRUS A
MAKE RIGHT ONTO LONE PINE DR; PROPERTY ON RIGHT SIDE OF RD, 4TH LOT FROM END OF CULDESAC
BUILDING INFORMATION
Unit Type of
No Establishment
1 RESIDENTIAL
E
W
4
[y/] RESIDENTIAL [ ] COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
6 3212
[ ] Floor/4��p*nt Dyainp [ ] Other (Specify)
J
SIGNATURE: DATE:
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved.
Property Identification
Site Address: 1408 Lone Pine Parcel ID: 3409-505-0014- Account #: 166414 Sec/Town/Range: 09/36S/40E
DR 000-5 Map ID: 34/09N Zoning: Planned Un
Use Type: 0000 Jurisdiction: Saint Lucie
County
Ownership Legal Description
Nicolas Khoury LONE PINE SUBDIVISION (PB 51-21) LOT 9
Misty Khoury
9773 SW Santa Monica DR
Palm City, FL 34990
Current Values
Historical Values 3-year
Just/Market:
$57,100 Assessed:
$24,647 Year Just/Market Assessed
Exemptions
Taxable
Exemptions:
$0 Taxable:
$24,647 2021 $57,100 $24,647
$0
$24,647
2020 $41,800 $22,407
$0
$22,407
2019 $36,000 $20,370
$0
$20,370
Sale History
Date
Book/Page
Sale Code Deed Grantor
Price
04-12-2021
4594 / 1051
0001 WD James -Walker Tiffany
$82,000
06-22-2012
3407 / 0642
0001 WD Oceans Four Development Corp
$11,000
05-14-2003
1714 / 2681
XX00 WD Taylor Eleanor R
$240,000
Primary Building Information
Finished Area of this building: 0 SF
Gross Sketched Area: 0 SF
Exterior Data
View:
Roof Cover:
Roof Stricture:
Building Type:
Year Built: N/A
Frame:
Grade:
Effective Year: N/A
Primary Wall:
Story Height: No. Units: 0
Secondary Wall:
Interior Data
Bedrooms: 0
A/C %: 0%
Electric:
Primary Int Wall:
Full Baths: 0
Heated %: N/A% Heat Type:
Avg Hgt/Floor: 0
Half Baths: 0
Sprinkled %:
0% Heat Fuel:
Primary Floors:
Total Areas
Finished/Under Air 0
(SF):
Gross Sketched Area 0
(SF):
Land Size (acres): 0.42
Land Size (SF): 18,373
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.
REFERENCE POINT: PAINTED NID S OF PROPERTY CL OF RD. LB7025