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STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
PERMIT #:56-SF-2317427
APPLICATION # : AP 1684484
DATE PAID•
FEE PAID:
RECEIPT #:
RECFVR1595281
DOCUMENT
AUG 0 2 2021
CONSTRUCTION PERMIT FOR: OSTDS New St. Lucia.0c)t.jr)t,.,
' Pefifiilfirl0
APPLICANT: (WJHFL, LLC)
PROPERTY ADDRESS: 5701 Shannon Dr Fort Pierce, FL 34951
LOT: 18 BLOCK
152 SUBDIVISION: Lakewood Park
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 1301-613-0363-000-1 [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 Septic 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 [ 600 ] SQUARE FEET
R [ ] SQUARE FEET
A TYPE SYSTEM: [ ]
I CONFIGURATION: [X]
N
F LOCATION OF BENCHMARK:
Drainfield New SYSTEM
N/A SYSTEM
STANDARD [X] FILLED [] MOUND
TRENCH [ ] BED [ ]
SITE BM FND NAIL ON N SIDE OF PROPERTY
I ELEVATION OF PROPOSED SYSTEM SITE [ 7.00 ]
E BOTTOM OF DRAINFIELD TO BE [ 1.00 ]
L
D F
O
T
H
E
R
FT ][ABOVE BELOW] BENCHMARK/REFERENCE POINT
FT ][ABOVE BELOW]BENCHMARK/REFERENCE POINT
ILL REQUIRED: [12.001 INCHES EXCAVATION REQUIRED: L J lrm+jo
The system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of
400 gpd.
P
i�
SPECIFICATIONS Y: Dianna May TITLE: CEHP
APPROVED BY: VVI• ITLE: Environmental Specialist II St. Lucie CHD
Nico e M nt nez
DATE ISSUED: 07/08/' 021 EXPIRATION DATE: 01/08/2023
ous ditions which may not be used)
DH 4016, 08/09 (Obsoletes all previ
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.9 AP1684484 SE1550969
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.
HEALTH
PAYING ON:
RECEIVED FROM:
PAYMENT FORM:
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
#..56-SF-2317427 BILL poc #:56-BID-5380125 CONSTRUCTION APPLICATION * AP1684484
Reliable Treasure Coast Services Septi AMOUNT PAID: $ 430.00
CREDIT CARD 764032 PAYMENT DATE: 06/30/2021
MAIL TO: (WJHFL, LLC)
N
FACILITY NAME:
PROPERTY LOCATION:
5701 Shannon Dr
Fort Pierce, FL 34951
Lot: 18 Block: 152
Property ID: 1301-613-0363-000-1
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
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 IAUDIT CONTROL NO. 56-PID-5067602