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HomeMy WebLinkAboutPaul B. Young - 43596PA 07 ?4, ST. LUCIE COUNTY PERMIT APPLICATION PERMIT NO. ( CODE # ) SEWAGE PERMIT NO. e.) All APPLICATION FOR PERMIT TO CONSTRUCT 4 JOB LOCATION/ADDRESS: LEGAL DESCRIPTION T7 35 Yc% w //y FT 0f /-- . <2is oc r df 5'.77)-1-7 l'z w 1/2- e� ✓v �zy o F _ sw %v e ss s UKjvtwAY rrRt�, RE`UIRED ROAD IMPACT: DISTRICT _ ZONE FEE i{ NnYes _=- S/D MAP FLOOD ZONE E _ e - 'Yn LOT BLOCK UNIT SEC y TWP RGE yo PROPERTY TAX ID # 2 t fV ^� 0 oc - ��'�� — ZONE GMPP ✓" LOT SIZE/DIMENSIONS EST COST SET BACKS: FRONT Yv, }s REAR 72' S SIDE _ 71 SQ FT BUILDING: LIVING AREA `,ACCESSORY 2? SIDE Y 'l ARCHITECT: NAME PHONE — ADDRESS CITY ST ZIP CONTRACTOR: STATE REG/CERT # — COUNTY CERT # NAME ©c�rYiFiC g ui�c�•�.v- ADDRESS CITY STATE ZIP — PHONE OWNER OF NAME fa v/ ✓� YOU7v� PROPERTY: ADDRESS �� � % v`� 0 J'` 1. PHONE Y CITY FT `L STATE �G ZIP Y STATE OF FLORIDA, COUNTY OF ST. LUCIE Before me, the undersigned authority, personally appeared , who upon being duly sworn, deposes and says that the information contained in the foregoing application is true and correct. Applicant �'% q. Sworn to and subscribed before me this day of ^G�" / SCHOOL IMPACT FEES Required [:]Yes ❑ No Notary Public, State of Florida at Large Amt. Pd My Commission expires: Date Pd Posted TFLORIDA L 'PAS I u.,, iar-x'a E.�` s.S., ,a^ `�'r�,� =..a- .....,7 >„ �,:az .�� "�a.'z9". ?, a,. �-::+p.;b _ �? �'��IkIY11i * s ;s= - Authority:Chapter 381, FS Chapter 10D-6, FAC Applicant --� Permit Number f pg3 , T I - SYSTEM CONSTRUCTION SPE IFICATIONS AND CONSTRUCTION APPROVAL -------------- Treatment Tank Minimum Drain'venci. 0"" Mindrn'Lim .ptz* zone Septic tank or Grease Size Bed Size aerobic unit���-.�o Septic tank or gallons interceptor gallons Square Feet d0 Square Feet aerobic unit gallons Dosing tank gallons Square Feet Square Feet GraYwater tank Laundry gallons Square Feet Square Feet waste tank gallons Square Feet Square Feet Other Requirements: (a) Installation must be in accord with requirements of chapter 10D-6, FAC. (b) A system construction permit is valid for a period of one calendar year from date of issue. (c) Final installation inspection and approv is re wired before the ysteM is covered. (d) Invert of stub -out for benchmark. Invert of stub -out for x s to benchmark. Invert of stub -out for _ _ _ laenchma k.- Invert of stub -out for to be to be benchmark (e) Fill quality and quantity: k r EXCAVATION MUST BE CHECKED R�►tFtEL� tiSTALLATION Other; SATURATION MOM ROOF DRAINAGE, stem desi 4 9n and specifications bTitle y. �,�. ,.{ nstrucrtion authorized by: �, , ,'; `f Date �_ _ _-rotyp Public Health Unit ote: Completecy 40opies of this form will be provided to the applicant, installer and the building department. UDIT CONTR® L NO. ,1 22 7 7 )ck Number!57 FormFeb 8 Eck - (soietes previous editions which may not be used) erv.44-00140 p b7—O) Page 1 of 2 Atli- A"Adb"�' N VOOAW^WA ow*^ ---mom x Lz 7K �7 t,5 Vz'z A,c OLi A I T IJ r,� t5 A _�F-�j CoL,urANS I JL7 M w-, n 0 •