HomeMy WebLinkAboutHealth Dept. Permit arts PERMIT # : 56=SF-2353251
STATE OF FLORIDA APPLICATION # : AP1715773
DEPARTMENT OF HEALTH DATE PAID :
3 + � ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID :
SYSTEM
RECEIPT # :
Wr',MI N21M'
DOCUMENT # : PR1650399
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT : (Port St. Lucie Properties)
PROPERTY ADDRESS : 85 Pinewood Ln Fort Pierce, FL 34947
LOT : 3 BLOCK : B SUBDIVISION : Sandalwood Estates
PROPERTY ID # : 2407-801 -0018-000-3 [ 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 ( 11050 I GALLONS / GPD Seotic New CAPACITY
A I ] 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 Has #Pumps I I
D [ 667 ] SQUARE FEET Drainfield New SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD (x ] FILLED [ I MOUND [ ]
I CONFIGURATION : [ I TRENCH [ xj BED ( ]
N
F LOCATION OF BENCHMARK : PAINTED NID CL OF RD E OF PROPERTY
I ELEVATION OF PROPOSED SYSTEM SITE ( 29,001 [ INCHES FT ] ( ABOVE BELOW ] BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE 117.001E INCHES FT it ABOVE BELOW ] BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED : ( 6,00 ] INCHES EXCAVATION REQUIRED : [ I INCHES
The system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of
O 400 gpd.
T
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SPECIFICATIONS BY : Matthew S Vajanyi TITLE : Environmental Specialist I
APPROVED BY : TITLE : Environmental Specialist I St. Lucie CHD
Matthew S Vajan
DATE ISSUED : 10/05/2021 EXPIRATION DATE : 04/05/2023
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 AP1715773 SE1596044
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 28A 06, 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 APPLICATION # AP1715773
'�� .., ' , n • to DEPARTMENT OF HEALTH PERMIT # 56-SF-2353251
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE1596844
vJ3 i .L�' SITE EVALUATION AND SYSTEM SPECIFICATION
War
APPLICANT : Port St, Lucie Properties
CONTRACTOR / AGENT : Alexander J, Piazza PSM, Inc
LOT : 3 BLOCK : B
SUBDIVISION : Sandalwood Estates ID# : 2407-801 -0018-000-3
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 CONFOR14S TO SITE PLAN : IX ] YES [ ] NO NET USABLE AREA AVAILABLE : 0,35 ACRES
TOTAL ESTIMATED SEWAGE FLOW : 400 GALLONS PER DAY [ RESIDENCES-TABLE / OTHER-TABLE 2 ]
AUTHORIZED SEWAGE FLOW : 525,00 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE : 1000,00 SOFT UNOBSTRUCTED AREA REQUIRED : 1000,00 SOFT
BENCHMARK/REFERENCE POINT LOCATION : PAINTED NID CL OF RD E OF PROPERTY
ELEVATION OF PROPOSED SYSTEM SITE 29,00 [ 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 : 75 FT NON-POTABLE : FT
BUILDING FOUNDATIONS : 5 FT PROPERTY LINES : 15 FT POTABLE WATER LINES : 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 15 10YR 4/1 Loamy Sand 0 To 12
10YR 6/3 Sand 15 To 24 1OYR 5/3 Loamy Sand 12 To 20
1 OYR 5/4 Sand 20 To 24 1 OYR 3/1 Sand 20 To 25
1 OYR 3/1 Sand 24 To 27 1 OYR 4/2 Sand 25 To 55
1 OYR 5/3 Sand 27 To 42 10YR 6/8 Sand 36 To 55
10YR 4/3 Sand 30 To 42 1 OYR 4/2 Loamy Sand 36 To 45
10YR 4/6 CMNlDST RF 36 To 42 2.5Y 6/2 Loamy Coarse Sand 45 To 55
1OYR 4/4 Loamy Sand 39 To 42 REFUSAL Refusal 55 To 72
10YR 6/1 Loamy Sand 42 To 50
REFUSAL Refusal 50 To 72
OBSERVED WATER TABLE : 48 ,00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE : [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION : 36 INCHES [ ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION : [ ] YES [ ] NO MOTTLING : [ X ] YES [ ] NO DEPTH : 36,00 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. 10YR4/6 CMN/DST RF mottling in 10YR4/3 matrix >2% starting @ 36" in 8131 .
SB1 29" above BM. SB2 30" above BM.
SITE EVALUATED BY : DATE : 09/24/2021
Va]anyi, Matthew (Tito: nvi ental Specialist 1) (Florida Department of Health In S
DH 4015 , OB/09 (Obsoletes previous editions w h y not be used) Incorporated: 64E-6 . 001 , FAC Page 3 of 4
AP1716773 EID2353251 v 1 .0.2
ttte
STATE OF FLORIDA PERMIT No .
" DEPARTMENT OF HEALTH DATE PAID :
` Q7 ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID :
SYSTEM RECEIPT # : fY1I-� Z
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR :
( VI New System [ ] Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair [ ] Abandonment [ ] Temporary [ ]
APPLICANT : MARK PEAVY
AGENT : KRISTENMONTALTO TELEPHONE : (772)336-0050
MAILING ADDRESS : 201 SW PSL Blvd. psi, Fl. 34984
------------------------------------------------------------------------------------
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 : 3 BLOCK : B SUBDIVISION : SANDALWOOD ESTATES PLATTED : Y
PROPERTY ID # : 2407-801-0018-000-3 ZONING : RS-3 I /M OR EQUIVALENT : [ No ]
PROPERTY SIZE : 0.34 ACRES WATER SUPPLY : [ ✓ ] PRIVATE PUBLIC [ ] <=2000GPD [ 1 >2000GPD
IS SEWER AVAILABLE AS PER 381 . 0065 , FS ? [ No ] DISTANCE TO SEWER : NA FT
PROPERTY ADDRESS : 85 PINEWOOD LANE, FORT PIERCE, FLORIDA .01i11C1N 'I
DIRECTIONS TO PROPERTY : FROM THE INTERSECTION OF ORANGE AVENUE AND SANDALWOOD DRIVE
HEAD SOUTH ON SANDALWOOD DRIVE UNTIL YOU COME TO THE TEE AND THE PROPERTY IS ON THE SOUTH
SIDE OF THE STREET,
BUILDING INFORMATION [ ✓ ] RESIDENTIAL [ ] COMMERCIAL
Unit Type of No . of Building Commercial / Institutional System Design
No Establishment Bedrooms Area S ft Table 1 Chapter 64E- 6 , FAC
1 SINGLE FAMILY 4
2
3
4
[ ] Floor/Equipment Drains [ ] Other ( Specify )
SIGNATURE . I � � 0� DATE :
DH 4015 , 08 / 09 (Obsoletes previous editions which may not be used)
Incorporated 64E- 6 . 001 , FAC Page 1 of 4
INS r4rs STATE OF FLORIDA PERMITAPPLICATION TO CONSTRUCTr
REPAID, MODIFYrORABANDONAWELL ParmSNo. 59 .32429
08aulhwesI Floado Unique l0
PLEASR FILL CUT ALLAP PP LID gne��LFIELDe
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` • ONodhviest ('penoles Raqulred Fleldewnere Applicable) permit Sllpulallone Required (Sea Attached)
I] St, Johns River
~ k0oulh Florida rhelvdtrnveaeanvatfodrtetpanrlefe(of ranNlalfn9
'• ��o LlSuwanneeRivef lanfalmnn111hAmrdingamprmllrnp/dlmlrantothe 02,524 Cited Not _DellnoalionNot
plvena L7DEP drnrdndaleAareanredaumanylpnaDnpppmwe.
cURNALIP Appueauon No,
CI Delegated Authority (if Applicable)
•dMark Joseph Stewart PeavY 711 Garden Avenue Ft Pierce ' FI 34982
Owner, LegalNamelfcorporation "Address dolly 'Slate 'ZIP Telephone Number
2. 85' Pinewood Lane Ft Pierce , FI 34947
'Well Location • Address, Road Name or Number, City
3,2407-801 -0018-000-3
'Parcel ID No. (PIN) orAllemate Key (Circle One) Lot BIB ok Unit
4, 97 35S 40E _ St Lucie Chock if 82.6240 Yes No
Secllon or Land Grant Tovmship Range 'County Subdivision
64 James Paul Tyson 11362 964-818-4269 downthehole@att.net
'Water Well Coniraotor 'License Number 'Telephone Number E•mall Address
6, PO BOX 881498 Port St. Lucie FI 34088
'Water Well Conlre toes Address Clly Slate ZIP
74 •rypeorWona onslruc on [] Repair E] MadlnoallonE] Abandonment
0. 'Number of Proposed W#Its I _ 'Ramon fort iS Medlew olbon D '..
D, 'Specify Intended Uae(s) of Wall(#): Q o a q tam D
Do calls Landscape Irrigation Agricultural Irrigation Site Investigations IJ-Ll
Bowled Water Supply B Recreation Area Irrigation B Livestock Monitoring
Public Water Supply (Limited Uso/OOH) [� Nursery Irdggllan Test
Public Water Supply (Community or Non•CnmmunllylOEP) Commorclallfnduslrlal Earth-Coupled Geothermal OCT - 5 20 1
Class I Injection Golf Course Inigellon HVAO Supply
HVAC Relurq_
Class V Injection: t] Recharge ❑ Commererallindusldel Disposal El Aquifer Storage end Recovery L] Dramage
Remedation: [I Recovery El Air $purge ❑ Other (DDaedbe) FD HO I St Lucie linty
other loaledba) nde aeon ALTH
f0."Dlslance from Santa System It S 200 R. 75+ 11 . Facility Description He 12, Estimated Start Data
13,'Esllmated Well Deplhl20 R, 'Eeilmoled Casing Depth 100 R, Primary Casing Diameter lit Open Hole: From =To ` _R, .
% Estimated Screen Interval: From100 To 120 it.
IS.'Prlmary Casing Material: Black Sleet Galvanized c [' 1- C Stainless Steal
Not Cased Other:
16, Secondary Casing: Telescope cooing Liner Surface Casing Olonlatar ` ln,
V. Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel Other
I0.dMolhod of Collshucllon• Repair, or Abandonment: • Auger Cable Toot Jetted ut4of ,r Santo
Combination (Two or More Methods) Hand Driven (Well Point, Sand Point) Hydraulic Point (Direct Push)
Horizontal Defiling Plugged by Approved Method Other cosedbot
10. Proposed Grouting Interval for ilia Primary, Secondery, end Ad a g;
Frem Q To �� Seal Material ( eenlonite niof Other 1
From. To _ Seal Material ( Benlonite aid
Cement Other 1
From To ,_ 'Seal Material ( eantonlle Neal Cement Other. 1
From To Seal Material ( Bonionito Nold Cement Other_ 1
20. Indicate total number of existing wells on site _ List number of existing unused welisansite
21:Is thl@ w��a� l��l ppr ggay errslIln well orw star will I an the owners co Ilguoue pprape��yy cppvggfed under a ConaumpllveMlater Use Pertrtl1ttlt CUPMJUP
or CC1PNUlJp AppllaRllongr 1�es N Ifyes, complete I�ie fakowlnB; CUPNVUP No. plsUlcl Well PD No. ( )
22, Lelltude Longo
23. Data Obtulned From: GPS Map Survey Dalum' NAD 27 NAD 83 WGS 84
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roadl(Ibm4palta e#DYedt,WlN Sad4Y#INlaa,pphaxY eIV4YM,Walen.eep4h,mpa4eYon.or, IDN4 Vnl114DQ.uVV Vr tan ,n riled rCMJM a Naa4dlYUJrprmil.
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hpproval Glanlod� > �� f lenoontgr � Explrnllon Date HydrologlatAppraval
Fad Received a / odalpt No, Chao k No, Ideal
THIS PERMIT IS NOT VALID UNTIL PROPERLY SIGNED aY AN AUTHORIZED OFFICER On REPRESENTATIVE OF THE WMD OR DELEGATED AUTHORITY, THE
PERMIT SHALL BE AVAILABLEAT THE WELL SITE DURING ALL CONSTRUCTION, REPAIR, MODIFICATION, OR ABANDONMENT AOTIVITIEO,
DEP Form: 02.632,o0aD) Inwrporolad In a2.632,40ap), F.A•0, hUdcllvo0ola; Oclobar7, 2010 Pace 1of2
Michelle Franklin , CFA -- Saint Lucie County Property Appraiser -- All rights reserved .
Property Identification
Site Address: 85 Parcel ID: 2407-801 -0018- Account k: 19936 Sec/Town/Range: 07/35S/40E
PINEWOOD LN 000-3 Map ID: 24/07S Zoning: RS-3 - Cou
Use Type: 0000 Jurisdiction: Saint Lucie
County
Ownership Legal Description
Mark Joseph Stewart Peavy SANDALWOOD ESTATES S/D BLK B LOT3 (0,35 AC)
711 Garden AVE
Fort Pierce, FL 34982
Current Values Historical Values 3-year
Just/Market: $29,400 Assessed: $29,400 Year Just/Market Assessed Exemptions Taxable
Exemptions: $0 Taxable: $2%400 2021 $29,400 $2%400 $0 $2%400
2020 $ 18,800 $ 18,800 $0 $ 18,800
2019 $ 189800 $ 16,500 $0 $ 16,500
Sale History
Date Book/Page Sale Code Deed Grantor Price
12-31 -2020 4534 / 0689 0001 WD Lystra Richard $36,900
03-08-2019 4241 / 2378 0001 WD Gil Mario $34,800
01 -08-2013 3472 / 2762 0111 WD Gil Mario $ 100
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:
Total Areas
Finished/UnderAir 0
(SF):
Gross Sketched Area 0
t " _Jq (SF):
Land Size (acres): 0.35
.t`'�� - Land Size (SF): 15,246
�xl 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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REFERENCE POINT:
PAINTED NID CL OF RD E OF PROPERTY