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HomeMy WebLinkAboutSEP �• PERMIT #: 56-SF-2296076 iE APPLICATION #:AP1666413 .e STATE OF FLORIDA DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: SYSTEM RECEIPT #: DOCUMENT #: PR15973O8 CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: William& Lauren Skopelja PROPERTY ADDRESS: 4931 Southwind Trl Fort Pierce, FL 34951 LOT: BLOCK: SUBDIVISION: PROPERTY ID #: 1418-241-0035-000-1 (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 [ 1,050 ] GALLONS / GPD SEDtic 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 [ 667 ] 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: NiD in UP near SE corner of property I ELEVATION OF PROPOSED SYSTEM SITE [ 44.00 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 34.00 ] [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [28.00] INCHES EXCAVATION REQUIRED: [ ] INCHES The system is sized for 2 bedrooms with a maximum occupancy of 4 persons(2 per bedroom),for a total estimated flow of O 400 gpd. T H E R SPECIFICATIONS BY: Brian J In# am TITLE: Environmental Specialist III APPROVED BY: TITLE: Environmental Specialist III St. Lucie CHD Brian J Vgram DATE ISSUED: 07/19/202f EXPIRATION DATE: 01/19/2023 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 v 1.1.4 AP1666413 SE1553963 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 E:e sr 5150 NW Milner Dr Port Saint Lucie, FL 34983 HEALTH PAYING ON: #:56-SF-2296076 BILL ooc#:56-BID-5324637 CONSTRUCTION APPLICATION#:AP1666413 RECEIVED FROM: G.M. Worlev AMOUNT PAID: $ 545.00 PAYMENT FORM: CHECK 18639 PAYMENT DATE: 05/26/2021 MAIL TO: William & Lauren Skopelja FACILITY NAME : PROPERTY LOCATION: 4931 Southwind Trl Fort Pierce, FL 34951 Lot: Block: Property ID: 1418-241-0035-000-1 EXPLANATION or DESCRIPTION: QUANTITY FEE 128 - OSTDS Construction System Inspection Research Fee 1 $ 5.00 -1 - Surcharge (Ail) 1 $ 45.00 -1 - OSTDS New Permit Surcharge 1 $ 100.00 -1 - OSTDS Construction Application and Plan Review,New 1 $ 100.00 123 - OSTDS Construction Site Evaluation 1 $ 115.00 126 - 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: AdamsC AUDIT CONTROL NO. 56-PID-5000112 Note: Well #59-32097 STATE OF FLORIDA PERMIT NO. -Z2A LeC)rl Le DEPARTMENT OF HEALTH DATE PAID: C�� ZA-(-' -2-1 ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: 5 !F?— SYSTEM RECEIPT V.V APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: (V New System SXigting Py6tQXTA H91ding Tank E lnnqvat�ve Repair Temporary APPLICaNT: Withilin m(l Lmmn Skoixt4i AGENT: GM Worley laic 1450 1115 TELEPHONE: (863)467-2541 mAILIN-W ADDREs$: I 10 NW 5th Street Okde.dlobve,1R.,3497� TO BE COMPLETED BY APPLICA-14T OR, APPLICANT'S AUTt�QRIZEV AGENT. SYSTEMS MUST BE CONSTRUCTED BY A PERSON LICENSED PUPSUANT TO 48P.105(3) (m) OR 409.552, FLORIDA $TATUTRS. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE DOCUMNTATION OF THE DATE THE LOT WAS CREATED OR PLATTED (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. PROPERTY INFORMATION LOT: ---- BLOCK: SUBDIVISION: PLATTED: PROPERTY ID #.- 1418-241-0035-000-1 ZONING: AR-1 X/M OR EQUIVALENT: [ No al I PROPERTY SIZE: 1.16 — ACRES WATER SUPPLY: I v) PRIVATE PUBLIC [ ]<-2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ No W I DISTANCE TO SEWER: PROPERTY ADDRESS: 4931 Sotitliwind'Trall Fort Pierco,11 14951 DIRECTIONS TO PROPERTY, Head east on Indrio Road-Take left omoSoutimindTrail tit 4900 111drio Rd- Property is the second to last parc(;l on the first block BUILDING INFORMATION RESIDENTIAL COMMERCIAL Unit Type of No. of Building Commercial/Institutional System Design No Establishment Bedrooms Area S. xt Table 1, Chapter 64E-6, FAC_ I Single Family 3 4 j Floor/Equipment Drains Other (Specify) SIGNATURE, DATE: DR 4015, 08/09 ((3bsoletess p. evious r 'tions which mar not be used) U4 tio Incorporated 64E-6.001, FAC Page I of 4 F STATE OF FLORIDA APPLICATION # AP1666413 �IFy i7 ,-.• DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM PERMIT # 56-SF-2296076 *b SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1553963 APPLICANT: William&Lauren Skopelja CONTRACTOR / AGENT: G.M.Worley LOT: BLOCK: SUBDIVISION: ID#: 1418-241-0035-000-1 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: 1.16 ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES-TABLEI�/ OTHER-TABLE 2 J AUTHORIZED SEWAGE FLOW: 1740.01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 1200.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1200.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: NiD in UP near SE corner of property ELEVATION OF PROPOSED SYSTEM SITE 44.00 [ INCHES / FT ] [ ABOVE /EEI BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES/SWALES: 77 FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 100+ FT NON-POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 21 FT POTABLE WATER LINES: 49 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X ]NO 10 YEAR FLOODING? [ ]YES [X]NO/ 10 YEAR FLOOD ELEVATION FOR SITE: FT [ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES: USDA SOIL SERIES: Munsell#/Color Texture Depth Munsell#/Color Texture Depth 1 OYR 3/1 Loamy Sand 0 To 8 1 OYR 3/1 Loamy Sand 0 To 5 1 OYR 511 Sand 8 To 29 1 OYR 5/1 Sand 5 To 28 1 OYR 6/1 Sand 17 To 29 1 OYR 6/1 Sand 14 To 31 1 OYR 7/1 Sand 29 To 34 10YR 7/1 Sand 31 To 41 1 OYR 411 Sand 34 To 46 1 OYR 2/2 Spodic Material 41 To 51 1 OYR 3/1 Spodic Material 46 To 61 7.5YR 4/4 Sand 51 To 63 7.5YR 4/4 Sand 61 To 72 1 OYR 5/3 Sand 63 To 72 OBSERVED WATER TABLE: 54.00 INCHES [ ABOVE / B-EL o-wl] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 14 INCHES [ ABOVE / BEE] EXISTING GRADE HIGH WATER TABLE VEGETATION: [X]YES [ ]NO MOTTLING: [X]YES [ ]NO DEPTH: 14.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Loamy Sand/0.60 DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [X ] BED [ ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA WSWT determined using USDA WSS and soil borings. 10YR6/1 stripping in 10YR5/1 matrix>10%with diffuse boundaries starting at 14"in S132. SB1 42"below BM. SB2 44"be ow BM. SITE EVALUATED BY: DATE: 07/16/2021 Ingram,Br (Title:Environmental Specialist III)(ENVIRONMENTAL HEALTH) DH 4015, 08/09 (Obsoletes previous editio which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 AP1666413 EID2296076 v 1.0.2 Michelle Franklin, CFA-- Saint Lucie County Property Appraiser--All rights reserved. Property Identification Site Address: 4931 Parcel ID: 1418-241-0035- Account#:7989 Sec/Town/Range: 18/34S/40E Southwind TRL 000-1 Map ID: 14/18N Zoning:AR-I Count Use Type:0000 Jurisdiction:Saint Lucie County Ownership Legal Description William R Skopeija 18 34 40 N 1/2 OF SE 1/4 OF NE 1/4 OF SE 1/4 OF NW 1/4- 6605 Green Dolphin ST LESS E 30 FT-(1.16 AC)(OR 4124-936) Fort Pierce,FL 34951 Current Values Historical Values 3-year Just/Market: $36,400 Assessed: $36,400 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $36,400 2020 $36,400 $36,400 $0 $36,400 2019 $36,400 $36,400 $0 $36,400 2018 $30,400 $28,270 $0 $28,270 Sale History Date Book/Page Sale Code Deed Grantor Price 04-20-2018 4124/0936 0001 WD Indirio Road Estates LLC $47,500 09-22-2011 3340/ 1668 0311 QC Kareias William G $100 I 1-01-1983 0422/0138 XX01 CV $4,500 Primary Building Information Finished Area of this building:0 SF Gross Sketched Area:0 SF Exterior Data View: Roof Cover: Roof Structure: 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: 1F' _ Total Areas Finished/Under Air 0 (SF): Gross Sketched Area 0 (SF): Land Size(acres): 1.16 Land Size(SF): 50,530 Total Building Count: 1 Special Features and Yard Items Type Qty Units Year Bit All information is believed to be correct at this time,but is subject to change and is provided without any warranty. ©Copyright 2021 Saint Lucie County Property Appraiser.All rights reserved. �: •�ww k ,4iit� 'ty, x ' w deR: y� 4n �� �r w�,anti k��! b a• d• �,� 'r Flu e �>yy�y�',,��SP.'�My' n'Y au.•p � t 11.1�� �,.u�i�.�..a G.XxY sec� �•- of • °��' � Ft' `� '° i� rim +��"tM �." � i.;ii` Y. i"' j k • x:e '0'., -F' gy. aa' : -£' -� n '!i t - �i xx ��At s 4 S,.s+ad'P rY�t xxr rzr si xi � k Ax F�x r ar t a3i�{ SM ;cif d+'-."��� `��{ �` ,r°� u,•. i '' '� a �'��'* � ;.L. ,.�03 gx�" ���' ••nc...:A -�!�j�; ��'K.t3 Vf t_� �.'}, � X r �Y��7, 'r i��.�, 4 G MIX 9 ...�^�W 4! �� � {i,�8 � • . .b, • Y:LA' " _ it Custom Soil Resource Report St. Lucie County, Florida 21—Lawnwood and Myakka sands Map Unit Setting National map unit symbol: 1jpvg Elevation: 0 to 200 feet Mean annual precipitation: 49 to 58 inches Mean annual air temperature: 70 to 77 degrees F Frost-free period. 350 to 365 days Farmland classification: Farmland of unique importance Map Unit Composition Lawnwood and similar soils:41 percent Myakka and similar soils: 39 percent Minor components: 20 percent Estimates are based on observations, descriptions, and transects of the mapunit. Description of Lawnwood Setting Landform: Marine terraces on flatwoods Landform position(three-dimensional):Talf Down-slope shape: Linear Across-slope shape: Linear Parent material:Sandy marine deposits Typical profile A-0 to 8 inches: sand E- 8 to 28 inches: sand Bh 9 -28 to 52 inches: sand Bh2- 52 to 58 inches: sand C-58 to 80 inches: sand Properties and qualities Slope:0 to 2 percent Depth to restrictive feature: 10 to 31 inches to ortstein Drainage class: Poorly drained Runoff class: High Capacity of the most limiting layer to transmit water(Ksat): Moderately low to moderately high (0.06 to 0.20 in/hr) Depth to water table:About 6 to 18 inches Frequency of flooding: None Frequency of ponding: None Maximum salinity: Nonsaline to very slightly saline (0.0 to 2.0 mmhos/cm) Sodium adsorption ratio, maximum:4.0 Available water capacity: Very low(about 0.9 inches) Interpretive groups Land capability classification (irrigated): None specified Land capability classification(nonirrigated): 4w Hydrologic Soil Group: A/D Forage suitability group: Sandy soils on flats of mesic or hydric lowlands (G156BC141 FL) 10 Custom Soil Resource Report Other vegetative classification: Sandy soils on flats of mesic or hydric lowlands (G156BC141FL) Hydric soil rating: No Description of Myakka Setting Landform: Flatwoods on marine terraces Landform position(three-dimensional):Talf Down-slope shape: Convex Across-slope shape: Linear Parent material. Sandy marine deposits Typical profile A -0 to 7 inches: sand E- 7 to 27 inches: sand Bh-27 to 38 inches: sand C-38 to 80 inches: sand Properties and qualities Slope: 0 to 2 percent Depth to restrictive feature: More than 80 inches Drainage class: Poorly drained Runoff class: High Capacity of the most limiting layer to transmit water(Ksat): Moderately high to high (0.57 to 5.95 in/hr) Depth to water table:About 6 to 18 inches Frequency of flooding: None Frequency of ponding: None Maximum salinity: Nonsaline to very slightly saline(0.0 to 2.0 mmhos/cm) Sodium adsorption ratio, maximum:4.0 Available water capacity: Low(about 4.5 inches) Interpretive groups Land capability classification(irrigated): None specified Land capability classification(nonirrigated): 4w Hydrologic Soil Group: A/D Forage suitability group: Sandy soils on flats of mesic or hydric lowlands (G156BC141FL) Other vegetative classification: Sandy soils on flats of mesic or hydric lowlands (G156BC141FL) Hydric soil rating: No Minor Components Ankona Percent of map unit:7 percent Landform: Flatwoods on marine terraces Landform position(three-dimensional): Talf Down-slope shape:Convex Across-slope shape: Linear Other vegetative classification: Sandy soils on fiats of mesic or hydric lowlands (GI 56BC141FL) Hydric soil rating: No Electra Percent of map unit: 7 percent 11 Custom Soil Resource Report Landform: Knolls on marine terraces, rises on marine terraces Landform position(three-dimensional): Interfluve Down-slope shape: Convex Across-slope shape: Linear Other vegetative classification: Sandy soils on rises and knolls of mesic uplands (G156BC131FL) Hydric soil rating: No Waveland Percent of map unit:6 percent Landform: Flatwoods on marine terraces Landform position (three-dimensional): Talf Down-slope shape:Convex Across-slope shape: Linear Other vegetative classification: Sandy soils on flats of mesic or hydric lowlands (G156BC141FL) Hydric soil rating. 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I ' N oo•37zz•a,es sir YA¢a g q 'g9C5 $ q pp i = z q ; ��°g �Zz ' s e3gge ! gpO m" a Sg -t Y Y2 ONAZD z, fn $�Soi 5 zm� 2 I m m z I a z a 7 m C I n m m m firG ' N m n C N � tl m 'Lmd ' � a 2. cn tJ pq m ----: soo•o7rorw fse.an- -- -- - Im .d _ c.sr vrr o Mc_■.�/•a sccnar�y-k,a ___. !jQnHWM°TPAR 5—Mrw[e6.7t 'py �^ -� S4D•Ww Moll ~- �^-{t`— artu■we faofao'a�rj n gr wo..i IMo DI Ron DeSantis Mission: Governor To protect,promote&improve the health of all people in Florida through integrated ` ^ U Scott A. Rivkees, MD state,county&community efforts. HEALTH m �y State 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 SLCDOH-WELLS(a)FLHEALTH.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(c)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,FL 34983 Public Health Accreditation Board PHONE:772/462-3800-FAX:772/871-5360 StLucieCountyHealth.com STATE.Oa:Rd DAPERMb's'AP PU.r.ATIaVTOCONSTRUCT,r r� ` Cdt Lv a, DaParF�a REPAiR,IsRt;Pf.YiMrORARANDONAWELL Permit No. 59-32097 o s' 4• O Southwest RWft Ut"4te ID PLEASE FILL OUT ALL APPt[GABL E FIELDS Otdorthwest ("Denotes Required Fields Where Applicable) Permit Stlptltatjons 12erstmact(Sea At"_ ea) t,Johns River The waterwellcortcractorlsrr, ansible orrom terin oUt17 F}Ofi d F f P T ^ t1Nsr5�rmandfibmwdenaMepermitanuffea ionrothe &2-524 Quad No. Delineation NO. o '' o suvvarxrlee River ©I�EP 'rPP�rctcdckflctrdmrt3ot;fywite:eefiplrnufs_ 'eantsI P� C IP AP&B Ew Na Owner,Legal Na ' >fi me if Co r2 iPo �A --fly 1P Tee aphorae Number "Wen Location-Address,Road Name or Number_City 3. *Parcel IDLNO. (PIN)or Altent ICE �/� r a i ' Block Unit 4'- 1— �• 1`1 Check if 82-524: OYES O No *Se t{on or La ant To wnship `Rangy Courtly Subdivd ton � "Water Well Con`ra or 'License Number 'Telephone Number E-r,:9'sl Address Water Well Contragtors Address City State ZIP 7. "Type of Work: Construdk7r, O Repair O Modification O Abandortrment 8. 'Numbar of Proposed Wefts___A"""^ Raasan for Repair,kkxTd r�tt 1`l 1 9. "Specify intended Use(s)of Wafi(Sy I LJ was4wzw Lad '10arnastic OaadscepatM;0at�, OAg adtntgawn 0 site kwesfiga..tions 08ottled Water Supply ❑Recreation Area Irrigation O L vestock O Monitoring ❑Public Water Supply(Lirrifted UseMOH) O Numeey Irrigation O Test J U l 1 9 2021 OPublic Water Supply(Community or Pion-Community/DEP) O Comrnerciatttndustrial O Earn„-Coupled Geathe mal CClass t Injection OGdsti Coarse l zigatian Oi KrAE empty O HVAC Rehm qDOH In St Lucie Cou Class V injection: 0Recharge OComrnerciaYindustdat Disposal OAqu"rl'erStorage and Recovery DDI`81nageE VIRONMENTAL HEA TF3 m OReczovery Mir S,parge OOther (Describe) OOther (Bescribel Official Use Only itt.=Uistance from Septic s stern rc 2c,s r:. ??.Facif�ty Description V 72.Estimated Start Date 13."Estimated Well Depth ft *Estimated Casing Depth#ofr. Primary Casing Diameter �r in. Open Hate: 3`rorrt To ft. 14.Estimated Screen Interval:FromAr. /To ft. 15.'Primary Casing lfllateriaY O eiack Steel OGalvanized C OStawass Steel O Not Cased O Other. 1S,Secondary Casing: OTetescope Casing O Liner O Sutzace-Casing Diarmeter in, 17.Secondary Casing-Material: Eh4adi Stec-i [heivanized e04VG OSlsintess Steel OOther 18,°Method of Construesion,Repair,or Abandonment: OAuger OCable Tool Jetted otary OSonic O Combination(Two or Mora Methods) Oyand Driven(Welt Point,Sand P01 t) O I;ydraul c Point(Direct Push) O H047orriat Drilling OPlugged by Approved Method OOther (oescribal 19.Propose routing l to v for the h`rareary,Seco ,y,and Additzortal Casing: From T( morile OI+-eat Cement OOther _} From To Seal Wwiai( S2ntonite ONeat Cement OOther From :o SQa1 beetesi3l{OSantomitz ONeat Cement OQther _J From To Seal Material(O Hite ONeat Cement 00ther } 20.Indicate total ntvnber of existiiV wel{s on site,,,____ List number of eta sire 21."is this well or any exiutiag a,-11 or.safer wb, d' n the owners contiguous property covered under a Consulnpt{veNVater Use Permit(CUPIWUP) or CUPANUP App,1icatipn7 Yes �••No if yes,complete the following:CUPMIUP No. lJi htt Well ID No. 22.Lazilude L.ongltt;de 23.Data Obtained From: OGPS Map OSurvey Datum: NAD 27 NAD 83 WGS 84 Paerctry dw tlraiiuc7.Mrn�y vdU�fh neLliraura:c:famce_A map Xtr.'mislratiw Cot::.aryl td,,zT 1p-tktt!t .Mtiss.v-.ref: p;rxc�t�a::+ta;rr ranticniry+fnsn iy nag:'Ee.and thNtam awnrc ot�m! uw uemPa a atiJioal re�arya Pernvl,Tnec:'ad.Tar 4aett arna`ba cat?med prta�as�rrre:wtmxN of u.T raspcm�.�atas..zer Chac=a:373.t7odrts 54wtas.ro mnbUnina Prapv�r a0seetm iNs uec:er.i ar�tifl ttud(nm cvawuaiva-t ranoar wnar coat ell P,aoMrar:n,Pro.•aw m res ra+aK.vann:n aeeurcec.^trs mm l wirl bt n ma ageta far the owner,that the tcfomrafia;,>=vasd itaC=M,ar41"Qit hwr urr_.rr Orc saner a thdir M,Vooayanxa. SarwC pulW. r.Ie ;si•H:.�aweR �e.anwsartreaaxreme.}noo�..o...:armn.croseowza...nuycr:G+naamntetworttawgatcdautho,ityc:.ea�: enrrq+lrsbn royan to Oro t)RrlrG' n 30 days alFar cart.FAsl6z:rC:trun� er.,rga+_i;,rsed'at!GetioS,yr rP:nc..ra eua ebrnv aw-rtmrreewr..e,�„r.,.-x:a'fsi�m rr:kncrxxrtanl9rsnrsi C7 w^s t�A R.dwMe02,A&&C'd hY this r th 7r1Ya a�ga6aflML w3ttUlP.ver WLinA first. reef onhac4or `� `L�rtsS ittl. _ `,:�.».:Jsc v��f _.... •II2le �_.. BEtDWTtFG U?iE SGEttkFXlAI.dSE UN1Y AQgrocr C,r3nted ETy M--- Issue oate ''j L i_F pimfi.Date LSFlydrologtstApproves-1 Fee Received $ Receipt No. ChacF N Pa1f d a THIS PERMIT IS NOT VALID UNTIL PROPERLY SiGNED BY AN AUTHORIZED OFFICER OR PsPRESENTATrvE OF THE IfVMD OR DELEGATED AUTHORITY. THE PERMIT SHALL 85 AVAILAI;LE ATTKF WELL SITE DURING ALL CONSTRUCTION,REPAIR,MODIFICATION,OR ABANDONMENTACTIVITIES. DEP Fomr.62-532.3CLt{?j dstclazcraterJ t; 6�53c.<Go(t},F. "C_ E;recdae Date:octotar 7.29ia Page 7 or 2 y r M oN)mmx mt,a 7r.Y£4ll .gt`itlt -,� pn,w"Au a.W1 air � qe ppaa a� 0 5' 90 balm till HIM �F p Is Sr V �V V Y P �C84 aR ^NQi.FPa � w^Ir"u� �$� tN1i�f(.RiL l Itra�a! 038),IPQ not^Appllcwt 319noiuv*Authorization r� .�•��*��v�r-^,�+�mc+iNFAA+F7!.�ah. . ._ _ •��..R+(.� ... awe..r.y„e.,.+nr,.,.,w..•.hr.,nr^!rr ,� fsii�otia:�l��a �r�����x�it (if�r��ii�gi��:�.,�.�.-- ».y...n.�,....,,..,��.,..,,.,�.,�.,.�•�:,._.r..�-n...,^�.9 I hof'4hy doAlgn4w arse#Wh ze ihra agont 1141ti WOW W act oil my boh*lf, or on 44hsgif of $ ;oy+orpumtIon,ao t4o suont to tho pro9oosir► this gpit on for the f ml#and/or, prQp4ot%ry rauOuviutionlndl ted*Oovo:an,� to furniph on M. uest Oupplprnontal information in oupport of thin oppllwtlon, In WeSlt kin, i+ v.ftrizo thio upent to 41tt0 all,or my ru x*tioi), to por€arm any roquirwant whioh m%y bo nopeo4ory to procure pormit or withorixo0on. F I uodoraiand that,knoOngiy making rmy t41#0 Otator"Onit or rOprOOuPIAt+on In U113 O.fspti t(Q1 I*a VoloWn of Smith$13,440, F.Se and 98 U.4.0 ScoWn 1001, j; '!S�e':"L Y• ✓�'.,m+T.f)tM'+A4ArPn.?^1tM i ' l /, �I n tum � utF� ri Typed!> rbna 0 Nmo wrl; ii� zat� 4 � I ... ]i.��s�.��A,?s- ,. ., �/�1•'�'it!{ Coiporektf 'Title If.ApplicAW4, slooatmro Dgtoc � r. A i S F I n tur l�ctthartx ti r►f rr+plAt MQ04404 9 i htfr�e'Ftmsft[th[ q rriF>~lm�ith i,AJ')nah,tllc.�urnkJAblt«. •^^- St. Lucie County Health Department E'T 5150 NW Milner Dr Port Saint Lucie, FL 34983 PAYING ON: #: BILL Doc#:56-BID-5324650 RECEIVED FROM: Ed's Wells & Pumps 11182 _ AMOUNT PAID: $ 115.00 PAYMENT FORM: CREDIT CARD 092841 PAYMENT DATE: 05/26/2021 MAIL TO: Ed's Wells & Pumps 11182 15505 82nd St Loxahatchee FL 33470 FACILITY NAME : Ed's Wells & Pumps 11182 PROPERTY LOCATION: 15505 82nd St Loxahatchee FL 33470 Lot: Block: Property ID: EXPLANATION or DESCRIPTION: QUANTITY FEE -1 - Well Construction 1 $ 115.00 RECEIVED BY: AdamsC AUDIT CONTROL NO. 56-PID-5000121 Note: 59-32097 -4931 Southland Trl - SF-2296076 Michelle Franklin,CFA—Saint Lucie County Property Appraiser—All rights reserved. Property Identification Site Address:4931 Soudtwind TRL Use Type:0000 See/Town/Range:I W4S/40E Account#.7999 Parcel ID:1418-241.0035-00(1-1 Map ID:14/18N Jurisdiction:Saint Lucie County Zoning:AR-1 Comm Ownership ` 'c a •r William R Skopcija k 6605 Green Dolphin ST Fort Pierce,FL 34951 y "� l; Legal Description IS3440N12OFSE114OFNE1/4OFSE1/4OFNW114-LESSE30FIL(1.16 AC)(OR 4124-936) Current Values Just/Markct Value: $36,400 Assessed Value: $36,400 Exemptions: s0 Taxable Value: $36,400 '^ ncacamsu+r.�w.muaa:. Property taxes are subject to change upon change of ownership. • Past taxes are not a reliable projection of future taxes, d • The sale of a ppropperty will prompt the removal of ail exemptions,assessment caps, and special cWssiricattonshi Total Areas Taxes for this.pan cl: SLC Tax Colfecto,'s OIRW iR Download TRIM for this parcel:Download PDF® Gross Sketched Air(SF): 0 Gross Sketched Area(SF): 0 Land Size(acres): 1.16 Land Size(SF): 50,530 Building Design Wind Speed Occupancy Category I H Ill&IV Speed [40 150 160 Sowccs/links: Sale History Date BookMage Sale Deed Grantor Price Code Apr 20,201 S 412410936 0001 WD Indi;-io Road F-iia s Lt.0 $47,500 Sep 27,2011 33401 166E 0311 QC Karelas WiI6arn G Wo Nov 1,1993 0422/0138 XX01 Cv $4,500 Aug 1,1978 0293/1475 XX00 CV $6,000 Building Information(i of 1) Finished Ana:0 Sr Gross Sketched Area:0 SF ExlcriorData Ycrv: Roof Cavcr. RurarStrucwn:: Building Type: Year Built:N/A Frame: Grade: FlIective Year.N/A Primary Wall: Story Height: No.Units:0 Secondary Wall: inferior Data Bedrooms:0 Electric: Primary lot Wall: Full Baths:0 Heat Type: Avg Hgt/Floor.0 Haimaths:0 Heat Fuel: Primary Floors: A/C%:0% Heated%:N/A% Sprinkled"/:0% Sketch Area Legend Sub Area Description Area Fin.Area Perimeter Special Features and Yard Items Type Qty Units Year Bit Current Year Values Current Values Breakdown Current Year Exemption Value Breakdown Building: so Land: S36,400 JuAmarket: $36.400 Ag Credit: so Save Our Hotnes or 10%Cap: So Assessed: $36,400 Exemption(s): so Taxable: $36,400 Current Year Special Assessment Breakdown This does not necessarily resent the total Special Assessetnents that could he charged against this property.The total amount charged for special assessments is reflected oil the most current tax staternmt and infonnaiian is available vd the SLC Tax Collectors Office 12. Historical Values Year Just/Market Assessed Exernptions Taxable 2020 $36,400 $36,400 s0 $36,400 2019 S36,400 $30,400 s0 $36,400 2018 S30,400 $28,270 s0 $28,270 Permits Number issue Date Description Amount Fee Notice:'rhn does not necessarily represent all the permits ibr this property. Click the following link to check for additional permit data in Saint Lucie euthnty 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. CiNIMHinosco t . a Nil CD cd CO eo AA to t w W a W � 1 s suj 4 a., P I : T � N A