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HomeMy WebLinkAboutHealth Dept. PermitSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: (Port St. Lucie Properties) PROPERTY ADDRESS: 5204 Hickory Dr Fort Pierce, FL 34982 LOT: 10 BLOCK: 52 SUBDIVISION: Indian River Estates PROPERTY ID # : 3402-608-0450-000-8 PERMIT #:56-SF-2338070 APPLICATION #: AP1702129 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1651351 [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 6.4E-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 [ 900 ] GALLONS / GPD Seotic 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 [ 500 ] SQUARE FEET Drainfield New SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [x] MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: PAINTED NID W OF PROPERTY I ELEVATION OF PROPOSED SYSTEM SITE [ 2.00 ][ INCHES FT ][ ABOVE BELOW]BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 9.00 ][ INCHES ET ][ABOVE BELOW] BENCHMARK/REFERENCE POINT L D F O T H E R ILL REQUIRED: [ ZO.UU] INCHES EXCAVATION REQUIRED: L j 11qU+jt!:s The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flaw of 300 gpd. SPECIFICATIONS BY: Matthew SSSVVa�ja�ny.i TITLE' Environmental Specialist I APPROVED BY:- TITLE: Environmental Specialist I � _� Matthew B va' DATE ISSUED: 09/30/2021 EXPIRATION DATE: DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC St. Lucie CHD 03/30/2023 Page 1 of 3 v 1.1.4 AD1702129 SC1597'741 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 DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: Port St. Lucie Properties CONTRACTOR / AGENT: Alexander Piazza LOT: 10 BLOCK: 52 sveDxvxsxoN: Indian River Estates xD#: 3402-608-0450-000-8 APPLICATION If AP1702129 PERMIT # 56-SF-2338070 DOCUMENT # SE1597741 TO BE COMPLETED SY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OA OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL, COMPLETE ALL ITEMS, PROPERTY SIZE CONFORMS TO SITE PLAN: EX ]YES [ ]NO NET USABLE AREA AVAILABLE: 0,23 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 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: 750,00 SQFT UNOBSTRUCTED AREA REQUIRED: 750,00 SQFT BENCHMARK/REFERENCE POINT LocATxoN: PAINTED ELEVATION OF PROPOSED SYSTEM SITE 2,00 / FT ] [I ABOVE I / BELOW ] BEtICH61ARK/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: 140 FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 10 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 QnTT. DRnTTT.P. TNTOPMLTTnN RTTP. 1 ROTT, PROFTLF. INFORMATION SITE 2 USDA SOIL SERIES: Munsell #/Color Texture Depth 1 OYR 4/1 Sand 0 To 38 1OYR 6/1 Sand 32 To 38 1 OYR 711 Sand 32 To 38 10YR 211 Spodic Material 38 To 40 REFUSAL Refusal 40 To 72 USDA SOIL SERIES: Munsell #/Color Texture Depth 10YR 4/1 Sand 0 To 26 10YR 5/1 Sand 17 To 26 10YR 6/1 Sand 21 To 36 10YR 7/1 Sand 26 To 36 10YR 2/1 Spodic Material 36 To 43 REFUSAL Refusal 43 To 72 USDA SOIL SERIES: Munsell #/Color Texture Depth 10YR 4/1 Sand 0 To 26 10YR 5/1 Sand 17 To 26 10YR 6/1 Sand 21 To 36 10YR 7/1 Sand 26 To 36 10YR 2/1 Spodic Material 36 To 43 REFUSAL Refusal 43 To 72 OBSERVED WATER TABLE: 32.00 INCHES [ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 17 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [ ]NO MOTTLING: [X]YES [ ]NO DEPTH: 17,00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/ DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: [ ] TRENCH [X] BED [ ] OTHER (SPECIFY) r REMARXS/ADDITIONAL CRITERIA iWT determined using USDA WSS and soil borings. 10YRS11 stripping in a 10YR411 matrix> 10 % with diffuse boundaries starting 17" In S132. SB1 3" above BM. SB2 2" above BM. 9ITE EVALUATED BY: " Vajanyl, Matthew 1;97t1e• vironmental Specialist I) (Florida Department of Health in 3 OH d015, OS/09 (Obaolatae pravioua editions nice may ba used) Incorporated: 6dE-6.001, FAC not INCHES DATE: 09/2 9/2021 Page 3 of 4 AP1702129 EID2330070 n Warr HEALTH PAYING ON: RECEIVED FROM: PAYMENT FORM: St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 #:56-SF-2338070 BILLDOC#:56-BID-5467381 CONSTRUCTION APPLICATION #: AP1702129 Alexander J Piazza AMOUNT PAID: $ 545,00 CREDIT CARD 002755 PAYMENT DATE: 08/04/2021 MAIL TO: (Port St. Lucie Properties) FACILITY NAME PROPERTY LOCATION: 5204 Hickory or Fort Pierce, FL 34982 10 Lot: PropertylD: 3402-6o8-oa50-oo0-8 EXPLANATION or DESCRIPTION: 52 Block: OSTDS Construction System Inspection Research Fee -1 - Surcharge (All) -1 - OSTDS New Permit Surcharge -1 - OSTDS Construction Application and Plan Review,New 123 - OSTDS Construction Site Evaluation 126 - OSTDS Construction Permit (New or Mod, Amendment) 127 - OSTDS Construction System Inspection 133 - OSTDS Construction Reinspection QUANTITY FEE 1 $ 45,00 1 $ 100,00 1 $ 100,00 1 $ 115,00 1 $ 55,00 1 $ 75,00 1 $ 50,00 RECEIVED BY: AdamsC AUDIT CONTROL NO. 56-PID-5116579 _- 3 n1E 4„ STATE OF FLORIDA DEPARTMENT OF HEALTH tp. ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: PERMIT No :V Z i l Ci DATE PAID: (} z FEE PAID: 5 RECEIPT #: [�/] New System [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT: Port St. Lucie Properties, Inc. AGENT: Alexander J. Piazza PSM, Inc. TELEPHONE: MAILING ADDRESS: 619 SW Biltmore Street, Port St. Lucie, Florida 34983 772-340-7770 ------------------------------------------------------------------------ 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: 10 BLOCK: 52 SUBDIVISION: Indian River Estates Unit 7 PLATTED: 1958 PROPERTY ID #: 3402-608-0450-000-8 ZONING: R I/M OR EQUIVALENT: [ No ] .23 PROPERTY SIZE: 0.30 ACRES WATER SUPPLY: [ PRIVATE PUBLIC [ ]<=2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381,0065, FS? [ No ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: 5204 Hickory Drive, Fort Pierce, FL 34982 DIRECTIONS TO PROPERTY: SEE MAP BUILDING INFORMATION Unit Type of No Establishment 1 RESIDENCE 2 3 4 [ �/ ] RESIDENTIAL [ ] COMMERCIAL No. of Building Commercial/Institutional System Design Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC 3 1,294 [ ] Floor/Equipment Other (Specify) GARBAGE GRINDERS/DISPOSALS SIGNATURE: DH 401508 Incorporate , ) DATE : 5-O5-2 1 APPLICANT'S Port St. Lucie Properties, Inc. LEGAL DESCRIPTION: Lot 10, Block 52, Indian Riyer Estates Unit 7 (PB 10, PG 75) FA PROPOSED SMMSYSTElf $UKINFORMT 'Mi. l 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 water 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 SURVEYOROR ENGINEER. dots/f'orms/septics/SepticApppPage207 CERTIFIED BY: .! FLORIDA PROFESSI A O.: 3b �- DATE: 0 / JO,B'NQ;' 21-7201 Page 4 of 4 Michelle Franklin, CFA--Saint Lucie County Property Appraiser -- All rights reserved. Property Identification Site Address:5204 Parcel ID:3402-608-0450- Account#:37530 Sec/Town/Range:02/36S/40E HICKORY DR 000-8 Map ID: 34/02S Zoning: RS4 Count Use Type: 0000 Jurisdiction: Saint Lucie County Ownership Legal Description Noelle Christine Massarda INDIAN RIVER ESTATES -UNIT 07- BLK 52 LOT 10 (MAP 131 SW Palm DR Apt 205 34/02S) Port St Lucie, FL 34986 Current Values Historical Values 3-year Just/Market: $14,400 Assessed: $9,984 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $%984 2020 $14,400 $%984 $0 $%984 2019 $113700 $%077 $0 $9,077 2018 $109000 $8,252 $0 $8,252 Date 05-20-2021 12-08-2014 09-12-2002 View: Year Built: N/A Primary Wall: Bedrooms: 0 Full Baths: 0 Half Baths: 0 Sale History Book/Page Sale Code Deed Grantor Price 4631 / 0571 0001 WD Paradigm Development Corp $44,000 3696 / 2755 0111 TD Multi Media Concepts Inc $1400 1583 / 0181 XX00 WD Schlais Thomas A $5,000 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: Building Type: Effective Year: N/A Secondary Wall: Primary Int Wall: Avg Hgt/Floor: 0 Primary Floors: Total Areas Finished/Under Air (SF): Gross Sketched Area (SF): Land Size (acres): Land Size (SF): Total Building Count: 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. 0 0 REFERENCE POINT: PAINTED NID W OF PROPERTY.