HomeMy WebLinkAboutApplication For Construction PermitSTATE OF FLORIDA
DEPARTMENT OF HEALTH
p ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
PERMIT NO. Q 9,5q
DATE PAID:
FEE PAID:.�
RECEIPT #:
[ ] New System [✓] Existing System [ ] Holding Tank [ ] Innovative
[ j Repair A/ [ ] Abandonment [ ] Temporary [ J
APPLICANT: /Y%/Z �Q � �,Q �/I�� Pt�j �/ C-e— '
AGENT: � �i W/ % /0,gi s� Re�/ T�T,EPHONE: 79 yl
MAILING ADDRESS : ,5-Q jI &7 14w A -7 fW�. AE- • S ( -J 1/
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 Q
LOT: fZ , BLOCK: SUBDIVISION: !{y� ) V /f �`>"' PLATTED:
PROPERTY ID #: 3 l r - 3 ZONING: I/M OR EQUIVALENT: [ Y / N ]
PROPERTY SIZE: 101 ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [ ]<=2000GPD [ ]>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ ON ] DISTANCE TO SEWER: /Dt) FT
PROPERTY ADDRESS :7 0 ` -4 --I 'e- / riW 4
DIRECTIONS TO PROPERTY: ��S/ B� l7 Il17 /�J� li'� /3f�1�1��U•�
JJs/ pig
BUILDING INFORMATION [ j RESIDENTIAL EX] COMMERCIAL
Unit Type of No. of Building Commercial/Institutional System Design
No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
2
3
0 Floor/Equip ent
SIGNATURE: N
ivvher (Specify)
k- Ot 1
DH 4015, 08/09 k(Obsoletek/previous editions which may not be used)
Incorporated 64E-6.001, FAC
DATE: it 15- -f
Page 1 of 4
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VISTA SOU ARD EAST PRIMA GRAPHIC SCALE
23
L LEGEND
VIf Al 3 4,
FDOH in St. Lucie CoUnty ju
Environmental Health
ID 6 KI"n
Septic System Appears Adequate
For Proposed Construction
This Approval Does Not Guarantee
Perfogfflance of t ystern
Reviewer:
�, � t . STATE OF FLORIDA PERMIT
fS _ } DEPART OF gFpr,T.fT
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
i` EXISTING SYSTEM AND SYSTEM REPAIR EVALUATION
APPLICANT: EDEN AGNEW
CONTRACTOR r AGEN7: ALL ABOUT SEPTIC SERVICES, INC
LOT: 12 & 13 BLOCK: 27 suBDiv: RIVER PARK UNIT 3 ID#: 34195150002010_
TO BE COMPLETED BY FLORIDA REGISTERED ENGINEER, DEPARTMENT EMPLOYEE, SEPTIC TANK CONTRACTOR OR
OTHER CERTIFIED PERSON. SIGN AND SEAL ALL SUBMITTED DOCUMENTS. COMPLETE ALL APPLICABLE ITEMS.
COMPLETE TANK CERTIFICATION BELOW OR NOTE IN REMARKS WHY THE TANKS CANNOT BE CERTIFIED.
EXISTING TANK INFORMATION
[900 ] GALLONS SEPTIC TANK F7-rl LEGEND: MATERIAL: FIBL''RGLAi BAFFLED: [ N Q]
[ ] GALLONS SEPTIC TANK LEGEND: MATERIAL. BAFFLED: [ Y ! N ]
L 1 LOOS EASM P T T GVN • ITS mTTn } T
L j Gni+i+viva Gi�caas. iiZTc.RCc.rTOF� .r.,a.vmLvD :
[ ] GALLONS DOSING TANK LEGEND: MATERIAL: # PUMPS:[ ]
II CERTIFY TF1R THE LI TED TANKS WERE PUMPED ON 11 /15 f2021 By Jason S r HAVE
THE VOL S S IED AS DETERMINED BY [ DII1 TISiONS, Li �LEGE�iD -.,� ] , ARE FREE OF OBSERVABLE
DEFECTS O AND HAVE A [ SOLIDS DEFLECTION�T DEVICE Q TTLET FILTER DEVICE' ] INSTALLED.
An About Septic 11/15/2021
SIGNATURE OF LICENSED CONTRACTOR BUSINESS NAME DATE
EXISTING DRAINFIELD INFORMATION
[675 ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM NO. OF TRENCHES
[ ] SQUARE FEET SYSTEM NO. OF TRENCHES
TYPE OF SYSTEM: r ii STZIINDPD,D r 1 FILLED [ i MOUNM r i
L� L
CONFIGURATION: [ ] TRENCH BED [ ]
DESIGN: [ ] HEADER [ ] D-BOX [V] GRAVITY SYSTEM
ELEVATION OF BOTTOM OF DRAINFIELD IN RELATION TO EXISTING GRADE
SYSTEM FAILURE AND REPAIR INFORMATION
] DIMENSIONS: 18 X37
] DIMENSIONS: X
[ ] DOSED SYSTEM
INCHES [ ABOVE BELOW j
r] 9']; ] SYSTEM TWSTAT.LATTON DATE TYPF, OF WASTE [ 1 DOMESTIC [ ] COWFRCTAT,
[ ] GPD ESTIMATED SEWAGE FLOW BASED ON [ ] METERED WATER [ ] TABLE 1, 64E-6, FAC
SITE [ ] DRAINAGE STRUCTURES
CONDITIONS: SLOPING PROPERTY
NATURE OF r ] HYDRAULIC OVERLOAD
FAILURE: [ j DRAINAGE /. RUN OFF
FAILURE [ ] SEWAGE ON GROUND
SYMPTOM: [ ] PLUMBING BACKUP
[ ] POOL [ ] PATIO / DECK [ ] PARKING
[ ]
[ ] SOILS r ] MAINTENANCE. r ] SYSTEM DAMAGE
[ ] ROOTS [ ] WATER TABLE [V] rb failure detached
[ ] TANK [ ] D BOX/HEADER [ ] DRAINFIELD
[✓] M failure detecbad
REMARKS/ADDITIONAL CRITERIACYSTEM APPEARS TO BE. WORKING AT THTS TIME..
Outlet filter is in place. (See attadied photo)
SUBMITTED BY: JASON HARRIS / V V TITLE/LICENSE SRO111693 DATE: 11/15/2021
DE!4015, Doi 09 (Obsole1.es PxEiu vo5 editi ons w1hi ch may 'iLot be u6ed)
Incornorated 64E-6.001, FAC Page 4 of 4
Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved.
Property Identification
Site Address: 787 NE PRIMA Parcel ID: 3419-515-0002- Account #: 42073 Sec/Town/Range: 22/36S/40E
VISTA BLVD
010-3 Map ID: 34/22S Zoning: Comm Offic
Use Type: 1900
Jurisdiction: Saint Lucie
County
Ownership
Legal Description
Evangelical Union of Fishermen Inc RIVER PARK -UNIT 3-BLK 27 LOTS 12 AND 13 AND FROM
3542 SW Vincennes ST
SE COR OF TRACT D RUN S 62 22 00 W 307.82 FT TO
Port St Lucie, FL 34953
CURVE CONC N, R OF 10 11. 10 FT, TH WLY ALG ARC 263.69
FT TO POB; TH CONT WLY ALG ARC 112.65 FT, TH N 0618
57 W 194.04 FT, TH N 62 22 00 E 36.65 FT, TH S 27 35 03 E
215.18 FT TO POB (0.87 AC — 37,841 SF) (MAP 34/22S)
Current Values Historical Values 3-year
Just/Market: $362,300 Assessed: $362,300 Year Just/Market Assessed Exemptions Taxable
Exemptions: $362,300 Taxable: $0 2021 $362,300 $362,300 $362,300 $0
2020 $359,400 $359,400 $0 $359,400
2019 $362,100 $362,100 $0 $362,100
Sale History
Date
Book/Page Sale Code Deed Grantor Price
08-20-2020
4464 / 2815 0317 WD Webb Properties LLC $550,000
02-10-2006
2490 / 2684 XX03 WD Webb Jack L $100
01-01-1900
$0
Primary Building Information
Finished Area of this building: 4,200 SF
Gross Sketched Area: 4,440 SF
Exterior Data
View:
Roof Cover: Tar & Gravel Roof Structure: BarJst/Rigid Building Type: LROF
Year Built: 1973
Frame: Conc Blk Grade: Y_C Effective Year: 1973
Primary Wall: CB Stucco
Story Height: 1 Story No. Units: I Secondary Wall:
Interior Data
Bedrooms: 0
A/C %: 100% Electric: MAXIMUM Primary Int Wall:
Full Baths: 0
Heated %: 100% Heat Type: FrcdHotAir Avg Hgt/Floor: 0
Half Baths: 0
Sprinkled %: 0% Heat Fuel: ELEC Primary Floors: Carpet
Total Areas
r Air 4,200 Finished/Under
.V
(SF):
w
Gross Sketched Area 4,440
(SF):
Land Size (acres): 0.87
Land Size (SF): 37,841
Total Building Count: 1
Special Features and Yard Items
Type Qty Units Year Blt
ASP2 LOW 1 12500 1970
CEMENT CURB 1 126 1973
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.