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STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Abandonment
APPLICANT: (SAYCO Equity Fund X LLC)
PROPERTY ADDRESS: 3219 Duban Ter Fort Pierce, FL 34982
LOT: 27,28.29 BLOCK
9 SUBDIVISION: Silver Lake Park
PROPERTY ID # : 2427-603-0124-000-3
PERMIT #:56-SF-2374884
APPLICATION #:AP1733755
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT # : PR1651578
[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
] GALLONS / GPD
] GALLONS / GPD
] GALLONS GREASE INTERCEPTOR CAPACITY
] GALLONS DOSING TANK CAPACITY [
D [ ] SQUARE FEET
R [ ] SQUARE FEET
A TYPE SYSTEM: [ ] STANDARD
I CONFIGURATION: [ ] TRENCH
N
F LOCATION OF BENCHMARK:
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D F
0
T
H
E
R
CAPACITY
CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
SYSTEM
SYSTEM
[ ] FILLED [] MOUND
[ ] BED [ ]
][ABOVE/ BELOW ]BENCHMARK /REFERENCE POINT
](ABOVE/ BELOW] BENCHMARK/REFERENCE POINT
'ILL REQUIRED: [ U.UU ] INCHES EXCAVATION REQUIRED: t J 1NL.;hz i
Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of
the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The
tank shall be filled with clean sand or other suitable material, and completely covered with soil.Have the system inspected
by the health department after it has been pumped and ruptured but before it is filled with sand and covered.
SPECIFICATIONS Y: TITLE:
APPROVED B : Environmental Specialist II
Nic e M ntan
DATE ISSUED: 10/012021 EXPIRATION DATE
DH 4016, 08/09 (Obsoletes all previous a ions which may not be used)
Incorporated: 64E-6.003, FAC
v 1.1.4 AP1733755 SE-1
St. Lucie CHD
12/30/2021
Page 1 of 3
A-
0W.-
STATE OF FLORIDAPERMIT NO.$f y
-Z-5?qDEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID:SYSTEMRECEIPT°fi APPLICATION FOR CONSTRUCTION PERMIT 457
APPLICATION FOR:
[ j New System [ ] Existing System [ ] Holding Tank [ ) Innovative
[ J Repair [r/] Abandonment ( ] Temporary [ ]
APPLICANT: SAYCO EQUITY FUND X LLC
AGENT: Reliable Septic Treasure Coast Indian River Septic
MAILING ADDRESS: P.O. Box 1116. Vero Beach, FL 32961
TELEPHONE: 772-562-4242
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: 27,28,29 BLOCK: 9 SUBDIVISION: SILVER LAKE PARK PLATTED: Pre-72
PROPERTY ID # : 2427-603-0124-000-3 ZONING. RM-11 I /M OR EQUIVALENT: [ Y
PROPERTY SIZE: .43 ACRES WATER SUPPLY: [ J PRIVATE PUBLIC [�]<=2000GPD [ ]>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y/0 ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: 3219 Duban Terrace Ft. Pierce, FL 34982
DIRECTIONS TO PROPERTY:
BUILDING INFORMATION
Unit Type of
No Establishment
1 Single Family Residence
K
3
[ V RESIDENTIAL [ ] COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
2 1188 Abandon existing tank for Demo of Residence.
4
[ ] Floor/Fcu3Pment Drains [ ] Other (Specify)
SIGNATURE: 1/ L;✓ DATE: 9/28/21
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC
Page 1 of 4
,je `k
�'O r
FDOH in St. ucie oun
Environmental Health
Site Plan Approved for Construction
Supersedes All Previous Site Plans for
OS nS #_5(� SF a3-1 4SV& Well #_
D, te: l0 i s i
/I 1 1 --t-- -Z% r q"1 -?"r ff-, - .w Ir
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.
Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved.
Property Identification
Site Address: 3219 Duban TER Parcel 1D: 2427-603-0124-000-3 Account #: 31737
Sec/Ibwn/Rangc: 27/35S/40E
Map ID: 24/27N
Zoning: RM-I I - Co Use Type: 0100
Jurisdiction: Saint Lucie County
Ownership
Legal Description
SAYCO EQUITY FUND X
LLC SILVER LAKE PARK ADDN BLK 9 N 1/2 OF LOT 27 AND ALL LOTS
7257 Mandarin DR
28 AND 29(OR 3977-1644)
Boca Raton, FL 33433
Current Values Historical Values 3-year
Just/Market: $112,300
Assessed: $95,299 Year Just/Market Assessed
Exemptions Taxable
Exemptions: $0
Taxable: $95,299 2021 $112,300 $95,299
$0 $95,299
2020 $87,300 $86,636
$0 $86,636
2019 S86,700 $78,760
$0 $78,760
Sale History
Date
Book/Pagc Sale Code Deed Grantor
Price
03-24-2017
3977 / 1644 0001 WD Dolbi USA LLC
$69,700
11-08-2016
3931 / 0456 0118 CT Harris Sr David C
$48,100
02-01-2005
2150 / 1743 XX01 QC French Lawrence E
$70,000
Primary Building Information
Finished Area of this building: 1,188 SF
Gross Sketched Area: 1,521 SF
Exterior Data
View:
Roof Cover: Roll Comp Roof Structure: Flat/Shed
Building Type: HC-
Year Built: 1956
Frame: Grade: C-
Effective Year: 1956
Primary Wall: CB Stucco
Story Height: 1 Story No. Units: I
Secondary Wall:
Interior Data
Bedrooms: 2
A/C %: 0% Electric: MAXIMUM
Primary lnt Wall:
Full Baths: 1
Heated %: 0% Heat Type:
Avg Hgt/Floor: 0
Half Baths: 0
Sprinkled %: N/A% Heat fuel:
Primary Floors: Tile -Ceramic
Total Areas
Finished/Under Air (SF):
1,188
Gross Sketched Area (SF):
1,521
Land Size (acres):
0.43
Land Size (SF):
18,750
Total Building Count:
1
Special Features and Yard Items
Type Qty Units Year Blt
CHAINLINK 4' 1 543 1999
UTILITY AVG 1 192 1999
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.
Reliable Septic aYid �ei-v3�.ces
TO: SAINT LUCIE COUNTY HEALTH DEPARTMENT
RE: 3219 DUBAN TER.
PERMIT: 56-SF-2374884
The above referenced property has been pumped out for
Abandonment on October 19, 2021.
If you have any questions, please contact our office.
Best regards,
n,
�Y
Bruce T. McCullers
P.O. BOX 1116 VERO BEACH, FLORIDA 32961 PH: (772) 562-4242 FAX: (772) 567-7183