HomeMy WebLinkAboutAPPROVED FDOH Septic PermitSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: (Port St. Lucie Properties, Inc.)
PROPERTY ADDRESS: 5406 Birch Dr Fort Pierce. FL 34982
PERMIT #:66-SF-2420134
APPLICATION #:AP1764305
DATE PAID:
FEE PAID:
RECEIPT #:
DocUMENT #: PR1707682
LOT: 4 BLOCK: 57 sueDlvxsxoN: Indian River Estates
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 3402-609-0182-000-1 [OR TAX ID NUMBER]
SYSTEM MUST
BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
3B1.0065, F.S.,
AND CHAPTER 64E-61 E.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
SBDfIC 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 Dralnfield New SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [XI MOUND
I CONFIGURATION: [ ] TRENCH [X] BED [ ]
N
F LOCATION OF BENCHMARK: NID SW OF PROP
I ELEVATION OF PROPOSED 3YS
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: [27,001
0
T
H
E
R
SYSTEM SITE [ 13.00 ]( INCHES FT ][ ABOVE BELOW ]BENCHMARK/REFERENCE POINT
[ 22.00 ] [ INCHES FT ] [ ABOVE BELOW ]
system is sized for 4 bedrooms with a max(mum occupancy of 8 persons (2 per bedroom), for a total estimated Flow of
gpd.
SPECIFICATIONS HY: Matthew 3 Vajanyi TITLE: Environmental Specialist I
POINT
APPROVED BY: � ^� TITLE: Environmental Specialist I $t. LUCIe CHD
Matthew a/jj) �jan '
DATE ISSUED: 01/03/2072 EXPIRATION DATE: 07/03/2023
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1,1.9 AP1.764305 aE1629090
[ 22.00 ] [ INCHES FT ] [ ABOVE BELOW ]
system is sized for 4 bedrooms with a max(mum occupancy of 8 persons (2 per bedroom), for a total estimated Flow of
gpd.
SPECIFICATIONS HY: Matthew 3 Vajanyi TITLE: Environmental Specialist I
POINT
APPROVED BY: � ^� TITLE: Environmental Specialist I $t. LUCIe CHD
Matthew a/jj) �jan '
DATE ISSUED: 01/03/2072 EXPIRATION DATE: 07/03/2023
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1,1.9 AP1.764305 aE1629090
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 850413-8743.
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 # AP1764305
DEPARTMENT OF HEALTH PERMIT # 56-SF-2420134
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT #SE1624040
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLxcANT: Port St. Lucie Properties, Inc.
CONTRACTOR / AGENT: Alexander J. Piazza PSM, Inc
LOT: 4 BLOCK: 57
suBDxvxsxoN:
Indian River
Estates ID#:3402-609-0182-000-1
TO BE COMPLETED BY
REGISTRATION NUMBER AND
ENGINEER,
SIGN AND
HEALTH DEPARTMENT
SEAL EACH PAGE OF
EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE
SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONE'ORMS TO SITE PLAN: [X ]YES [ ]NO NET USABLE AREA AVAILABLE: Q,2$ ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 575,01 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:
ELEVATION OF PROPOSED SYSTEM SITE
13.00 [ INCHES / FT
] [ ABOVE / BELOW ] HENCH[9�IU(/REFERENCE
POINT
THE MINIMUM SETBACK WHICH CAN HE 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: 100
FT NON -POTABLE:
115 FT
BUILDING FOU➢DATIONS: 15 FT
PROPERTY LINES:
5 FT
POTABLE WATER LINES:
35 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
c! 1 ROTT, DROFTT.F. INFORMATION SITE 2
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
10YR
5/1
Sand
0 To 12
1 OYR
7/1
Sand
12 To 39
1 OYR
712
Sand
32 To 39
1 OYR
211
Spodic Material
39 To 51
10YR
4/3
Loamy Sand
51 To 68
1 OYR
2/1
Spodic Material
68 To 69
REFUSAL
Refusal
69 To 72
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
10YR
6/1
Sand
0
To
24
10YR
7/1
Sand
15
To
37
10YR
7/2
Sand
24
To
37
10YR
2/1
Spodic Material
37
To
48
7.5YR 413
Sand
48
To
60
tOYR
413
Sand
60
To
72
OBSERVED WATER TABLE: Q$,QQ
INCHES [ABOVE
EXISTING GRADE
TYPE:
[ PERCHED / APPARENT
ESTIMATED WET SEASON WATER TABLE
ELEVATION; 15
INCHES [ ABOVE
/ BELOW ]
EXISTING GRADE
HIGH WATER TABLE VEGETATION:
[ ]YES [X]NO
MOTTLING: [X IYES
[ ]NO
DEPTH: 15.00 INCHES
/ SELOW ]
902E TEXTURE/LOADING RATE
FOR
SYSTEM SIZING:
$and/0.60
DEPTH OF EXCAVATION:
WSWT determined using USDA WSS and soil borings. 10YR711 stripping in a 70YR6/1 matrix > 10% with diffuse boundaries starting
at 16" in SB1. S81 12" below BM. S82 13" below BM.
SITE EVALUATED BY:
Va]anyl, MaKhew�3ttla: Environrydnlal Specialist I) [Florida Department of Haalm In 5
DH 4015, OB/09 (Obaoletea previone editions which niay not be used) Incorporated: 69E-6.001, FAC
AP17843D5 EID2420134
INCHES
DATE: 12/28/2021
Page 3 of 4
v 1.0.2
SITE EVALUATED BY:
Va]anyl, MaKhew�3ttla: Environrydnlal Specialist I) [Florida Department of Haalm In 5
DH 4015, OB/09 (Obaoletea previone editions which niay not be used) Incorporated: 69E-6.001, FAC
AP17843D5 EID2420134
INCHES
DATE: 12/28/2021
Page 3 of 4
v 1.0.2
AP17843D5 EID2420134
INCHES
DATE: 12/28/2021
Page 3 of 4
v 1.0.2
St. Lucie County Health Department
hIEAA.4" 5150 NW Milner Dr Port Saint Lucie, FL 34983
PAYING ON: a:56-SF-2420134 BILLooca:56-BID-5699517 CONSTRUCTION APPLICATION N: AP1764305
RECEIVED FROM: Alexander J. Piazza PSM, Inc AMOUNT PAID: $ 545.00
PAYMENT FORM: CREDIT CARD 001003 PAYMENT DATE: 11/16/2021
MAIL TO: (Port St. Lucie Properties, Inc.)
FACILITY NAME
PROPERTY LOCATION:
5406 Birch or
Fort Pierce, FL 34982
4
Lot:
57
Block:
Property ID: 3402-609-0182-000-1
EXPLANATION or DESCRIPTION:
QUANTITY
FEE
128 - OSTDS Construction System Inspection Research Fee
1
$
5.00
-1 - Surcharge (All)
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: WhighamJL AUDIT CONTROL NO. 56-PID-5366773
d T11E`
STATE OF FLORIDA
DEPARTMENT OF HEALTH
tp. ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
° 1%f APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[✓] New System [ ] Existing System [ ] Holding Tank
[ ] Repair [ ] Abandonment [ ] Temporary
APPLICANT: Port St. Lucie Properties Inc.
AGENT
MAILING ADDRESS:
PERMIT NO. S� ()
DATE PAID: b4--
FEE PAID:
RECEIPT #:
[ ] Innovative
[ ]
Alexander J. Piazza PSM, Inc. TELEPHONE: 772-340-7770
619 SW Biltmore Street, Pod St. Lucie, Florida 34983
----------------------------------------------------------- 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: 4 BLOCK: 57 SUBDIVISION: IndianRlverEStateSUnit8 PLATTED: 1958
PROPERTY
ID #:
3402-609-0182-000-1 ZONING: R
I/M ORE IVALENT: [ No ]
PROPERTY
SIZE: 0.23
ACRES WATER SUPPLY: [ ] PRIVATE
PUBLIC [ <=2000GPD [ 1>2000GPD
IS SEWER
AVAILABLE AS
PER 3B1.0065, FS? [ No ]
DISTANCE TO SEWER: FT
PROPERTY
ADDRESS:
5406 Birch Drive, Fort
Pierce, FL 34982
DIRECTIONS TO PROPERTY: SEE MAP
BUILDING INFORMATION [✓] RESIDENTIAL [ ] COMMERCIAL
Unit Type of No. of Building Commercial/Institutional System Design
No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
I RESIDENCE 4
99
2
3
4
[ ] Floor/Equipment Drains [ /] Other (Specify) GARBAGE GRINDERS DISPOSALS
Alexander J Piazza ®"� � FIM" �fi" AO]41 �'� 179MDL72�1°'M
SIGNATURE: DATE: 9- I6-2021
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
APPLICANT'S NAIME:
Port St. Lucie Properties, Lic,
LEGAL DESCRIPTION: Lot 4, Block 57, Indian River Estates Unit 8 (PB 10, PG 73)
PROPOSED SETSCSYSTEM INFORM :
I certify that there are no potable private wells within 75 feet Of the available area for the
proposed septic system, that there are no non -potable wells within 50 feet of the available area
for the proposed septic system, that there are no wells within 25 feet of a pesticide -treated
building foundation; that there are no public wells that serve less than 25 people or less than
15 homes or businesses within 100 feet of the proposed septic system, that there are no public
wells that serve more than 25 people or more than 15 homes or businesses within 200 feet of
the proposed septic system, that the water line from the watef meter or well to the structure is
at least 10 feet from the available area for the proposed septic system unless the plans show
the line to be double sleeved, that there is not a gravity sewer line, low pressure sewer line or
vacuum sewage line in a public easement or right -of --way that abuts the property, that there
are no lakes, streams, wetlands, or surface water within 75 feet of the available area for the
proposed septic system unless the property was created prior to 1972, that the septic system is
proposed on the side of the lot farthest from surface water, that all private wells, septic
systems and surface water on adjacent or contiguous land within 75 feet of the applicant's lot
are shown on the site plan, that all public wells within 200 feet of the applicant's lot are
shown on the site plan, and that the location of building or residences, swimming pools,
recorded easements, paved areas or driveways, sidewalks, the general slope of the property,
filled areas, drainage features, and surface waters such as lakes, ponds, streams, canals, or
wetlands are shown on the applicants lot.
The natural grade elevation in the area of the proposed septic system and the benchmark must
be shown on the site plan. Please locate the benchmark within 200 feet of the proposed septic
system.
NOTE: MUST BE CERTIFIED BY A FLORIDA
REGISTERED SURVEYOR OR ENGINEER.
CERTIFIED BY:
FLORIDA PROFESSIONAL NO.: p6330 a�
DATE: 09/16/21 JOB NO.: 21-7821
dots/t'orms/septics/SepticApppPage207
Page 4 of 4
Property Card
Page 1 of 1
Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved.
Property Identification
Site Address: 5406 BIRCH Parcel Ill: 3402-609-0182- Account #: 37736 Sec/Town/Range:
DR 0004 11/36S/40E
Map ID: 34/1 IN Zoning: RS-4 Count Use Type: 0000 Jurisdiction: Saint Lucie
County
Ownership Legal Description
AJ Chandler LLC INDIAN RIVER ESTATES -UNIT 08- BLK 57 LOT 4 (MAP
765 Alamanda ST 34/1 IN)
Boca Raton, FL 33486-3566
Current Values
Historical Values
3-year
Just/Market $20,900 Assessed: $13,310 Year
Just/Market
Assessed
Exemptions
Taxable
Exemptions: $0 Taxable: $132310 2021
$2%900
$13,310
$0
$133310
2020
$14,400
$12,100
$0
$125100
2019
$11,700
$II,000
$0
$11NO
Date
03-04-2021
12-15-2016
08-05-2005
View:
Year Built: N/A
Primary Wall:
Bedrooms: 0
Full Baths: 0
Half Baths: 0
Sale History
Book/Page Sale Code Deed Grantor
4569 / 2087 0001 WD Little Shawn
3943 / 2276 0001 WD Rosen Mark
2333 / 1179 XX00 WD Goldman Robert
Primary Building Information
Finished Area of this building: 0 SF
Gross Sketched Area: 0 SF
Roof Cover:
Frame:
Story Height:
Heated %: N/A%
Sprinkled %: 0%
Exterior Data
Roof Structure:
Grade:
No. Units: 0
Interior Data
Electric:
Heat Type:
Heat Fuel:
Total Areas
Price
$39,000
$10,000
$63,900
Building Type:
Effective Year: N/A
Secondary Wall:
Primary Int Wall:
Avg HgUFloor: 0
Primary Floors:
Finished/Under Air 0
(sF):
Gross Sketched Area 0
(SF):
Land Size (acres): 0.23
Land Size (SF): 10,000
Total Building Count: I
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.
® Copyright 2021 Saint Lucie County Property Appraiser. All rights reserved.
https://www.paslc.gov/RECard/ 11/16/2021
REFERENCE POINT: NID SW OF PROPERTY