HomeMy WebLinkAboutConstruction Permit°kTq� STATE OF FLORIDA
.>-. DEPARTMENT OF HEALTH
Y 'ts ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
R,
*NSTRUCTION PERMIT FOR:
R ]Na;w System [ ]Existing System [ ]Holding Tank [
[ ]Repair [ ]Abandonment [ ]Temporary [
APPLICANT: Dale / WC Custom Homes AGENT:BLOOMSTER PLS
PROPERTY STREET ADDRESS: S Indian River Dr Fort Pierce FL 24982
CENTRAX #: 56-SF-08964
DATE PAID:
FEE PAID $
RECEIPT
OSTDSNBR 06-0337--N
] Innovative Other
LOT: BLOCK: SUBDIVISION:
[Section/Township/Range/Parcel No.]
PROPERTY ID #: --- [OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E-6,FAC'�
DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
PERIOD. 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 PROPERTY DEVELOPMENT.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 1200 ]Gallons SEPTIC TANK MULTI-CHAMBERED/IN SERIES: [Y ]
A [ 0 ]Gallons MULTI-CHAMBERED/IN SERIES: [Y ]
N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY
K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 ]DOSES PER 24 HRS # P S[ 0 ]
D [ 625 ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM �Url..�l 6yl
R [ 0 ]SQUARE FEET SYSTEM ��!!
A TYPE SYSTEM: [ Y ]STANDARD [ N ]FILLED [ N ]MOUND
I CONFIGURATION: [ N ]TRENCH [ Y ]BED [ N ]
N
F LOCATION TO BENCHMARK: Nail In East Side of Road Near South Property Line (See Site Plan) t
I ELEVATION OF PROPOSED SYSTEM SITE [ ] [ INCHES ] [ ABOVE] BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 16.0 ] [ INCHES ] [ ABOVE] BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED:[ 0.0 ]INCHES EXCAVATION REQUIRED: [ 0.0 ] INCHES
OTHER REMARKS:
The licensed contractor installing the system is responsible for installing the minimum
category of tank in accordance with s. 64E-6.013(3)(f), FAC.
Bottom of drainfield to be no more than 30" below existing grade at time of installation.
There's to be 6" - 18" cover over top of drainfield.
0
SPECIFICATIONS BY: POLISSKY, JODI TITLE:
APPROVED BY: Polissky, Jodi ( JT TITLE: Environmental Spec St. Lucie CHD '
'DATE ISSUED: 7/17/06 EXPIRATION DATE: 1/17/08
DH 4016, 03/97 (obsoletes previous editions which may not be used)
"Stock Number: 5744-001-4016-0) (ostds_cons _4076-11 Page 1 Of 2