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Home My WebLink AboutOSTDS NEWSTATE OF FLORIDA DEPARTMENT OF iHEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR.: QSTD.S New APPLICANT: (Treasure Coast Home: Builders LLG) PROPERTY ADD.RE$S: 6504 Bayard Rd_ Fort'Pierce, FL 34951 PERMIT #:56-SF-2349636 APPLICATION #: AP1718212 DATE PAID• FEE PAID: RECEIPT #: DOCUMENT #: PR1.6501.72 LOT: 12 BLOCK: 132: svBbiv=sioN:: Lakewood -Park. ['SECTION, TQWNSHIP; RANGE., PARCEL NUMBER] PROPERTY `ID #: 1:31]1,612-0328-000-1 [OR T;M ID NUMBER] SYSTEM MUST BE CONSTRUCTED =N ACCORDANCE WITH SPECIFICATIONS AND -STANDARDS OF SECTION 381.006:5:., 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', [i7HICH SERVED AS A BASES FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY REBUT IN THIS PERMIT BEING MADE. NULL AND VOID.. .. FROM COMPLIANCE WITH: .OTHER ISSUANCE DF THIS PERMIT DOES NOT EXEMPT THE, APPLICANT FEDERAL:, STATE., OR LOCAL PERMITTING REQUIRED FOR.DEVELOPMSNT'OF TH=S PROPERTY. SYSTEM,=DESIGN AND SPECIFICATIONS GALLONS. / GPD` SeDtiG'new CAPACITY A [ ] GALLONS /• GPD N/A CAPAC=TY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPPCI.TY SINGILE'TANK.-I-250 GALLONS] K [, ] GALLONS DOSING TANK CAPACITY [ JGALLONS @[. ]DOSES PER 24 HRS #Pumps [ D [ 667 ]SQUARE FEET Drainfield, new SYSTEM R [ ] SQUARE FEET N/A. . SYSTEM A TYPE SYSTEM: ['.] STANDARD Lx] FILLED [,], MOUND L ] I CONFIGURATION; E. ] TRENCH [X.] BED [ ] N F LOCATION OF BENCHMARK: Site: B..M, TP STET MNOT no 10, elev. 20.69 neaj east P, extended .S. T ELEVATION OF PROPOSED SYSTEM SITE [ 15 O0 ] .[ .INCHES. ET ] [ABOVE BELOW ]:BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 13 Q17 ]I :INCHES FT It BELOW ] BENCHMARK/REFERENCE POINT L D REQUIRED• [ 16001 INCHES EXCAVATION REQUIRED: [ 45;UU ] INCHES aysfem is sized for 4 bedrooms with a max[mum occupancy of 8 persons (2 per bedroom), for a total estimated flow of gpd. SPECIFICATIONS BY: TITLE: Brian J gram Environmental Specialist ITI APPROVED BY: TITLE: Environmental Specialist :III St. Lucie CHD Brian ngram DATE ISSUED: Ogi24/2 1 EXPIRATION DATE: 0.3/2412023 DH 4,01.6, 06/09 (Ubsoletes all previous editions which .may not be used) Incorporated: 64E-6,.003, FAC Page 1 of 3 v 1.T.4 AP1713212 SE1596627 NOTICE OF RIGHTS A party, Whose substantial interest is affected by this order may petition for an administrative hearing pursuaritto sections 120.569 and 120.57, Florida Statutes. Such proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for gdmihi*s'frative h,.etir*ihg must be in Writing and -must be received by the Agency Clerk for the Department, within: twenty-one (21) days from the: receipt of I this: drd . er. T . he address of the Agency Clerk it, 4052 'Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency lerW.5 facsimile. number is: 850-413 8148. Mediation is riot available; -as an -alternative remedy, Your failure to submit ia petition -for, hearing within 21 days from. receipt: of this order will constitute a waiver of'your,r9 . ht: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 Sectflon'120.68-i Florida, Statutes. Review proceedings are governed by the Florida Rules Qf.Appellate *Procedure. Such proceedings maybe! commenced by fling: one. copy of a Nofice of Appeal with the Agency Clerk, of the Department of Health and a seconda W Court of Appeal in the 'copy, acpqrtippmed by -the filing, fees by law, with the Cou approp(fate'DI'strictCoort. The. notice must be, filed within 30 days of rendition- of the final order. St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 PAYING ON: #-56-8F-2340686 13ILLDO&#-56-BIDr5508082 CONSTRUCTION APPLICATION#. AP17132,12 RECEIVED D FROM: Narlan Nar.qen. AMOUNT PAID: .$660.00 PAYMENT FORM: CREDIT.C-ARD.000747. PAYMENT DATE: 08/1.0/2021 MAIL TO: (Treasure Coast Home Builders LLC) FACILITY NAME: PROPERTY LOCATION: 6504 Bayard Rd P6rt.Pie.r.ce,,F*L 34951 Lot-' 12' 132 Block: Property ID, 1301612-032&0 . 00-1 EXPLANATION or DESCRIPTION: QUANTITY FEE 128 - OSTDS Construction System Inspection Research Fee 1 $ 5.00 -1 - Surcharge (All) 1 $ 45.00 -1 - OSTDS NOW -Perrhit Surcharge 1 $ 100.00 -1 - OSTDS. Construction Application and Plan Review, Now 1 $ 100.00 123 - 08TO8 -Construction Site Evaluation 1 $ 11.5.00 126 - OSTDS Construction Permit (New or Mod, Amendment) 1 $ 55.00 127 - OSTDS ConstructionSystem Inspection 1 $ 75.00 133 - OSTDS Construction. Reinspection 1 $ -50.00 -1 - Well Construction 1 $ 115.00 RECEIVED BY: AdahisC. AUDIT CONTROL NO. 56-PID-5148970 Note:Mell#59432379 411-5q -3z3 ill STATE QF FLORIDA, NO., sr-�05�h t-051-a 04MAT 00- AEA.4-TH DATE PAID:: QX-,9XTE SEWAGE T. h2ATHIMT. AM DTSPOSAL FEE P-At.b.: Lot-e:qc� SYSTEM R.ECEIRT (C-> APPLt.C-AtT(JN FOR CONft.-RUCTI-Olq PERMIT kPPLIC.47MON, rift. [',/I New System Exisin System Holding ..E Jrnnovative r J. nqpg�x Abandbnn'(ent Temporary APPLICANT: ZZA .3 4,t�, G Cd A-5 AGENT; A119JOl AW AIAR4.; / TELMIONE-, -77d-9A0E-S-qSY MAILINGADDRES'S ; l Z )� d`!L% l/1;�• : i'.Ilg !/T //N / C -Iil �i 14�G 3.9� 3 TO BE ddMP.LtT9b 'by.-APjiLICANT OR k�-PhxckmtS AUTHORIZED Adk-,8y8TFk$ X'UST BE-COXSTAft TED BY 'A P.BR.SON LICENSIPP. PdRliUMT, TO (ld) OR 4:8-9.552., FLOA;-W4.ATATDT MS. IT IS THE APPLICANT'S AtbV6lT9lZjLX i - TY T, - PROV-XDZ,'D - PEIN4NUTIDN OF THE. E. DATE T11E L6T WAS CREATED p4AT�-#, -.,(=/Do/,Yy,) ----to ittottsTitim ColtiDERATtox dk sifAviT61tY Gi�r=lti it PAOvt9t0--NS;. PROPERTY 1.09 LOT'.- ZAA N(;, g!�# I/M 0 EQUIV=EXT, . (' Y[N j :PROPERTY ID �f: ZONING; R. PROPERTY 5SZE,; or�l, Amts WATER SUPPLY-: t V!, PRIVATE PUBLIC [ ])<-2.000GPD >20.000PD IS SEWER AVAIMABWl AS PER 3:91. 0 0,65, Y /(9 DISTANCE TO SbW4. FT LI71 PROPERTY .ADDRESS: 16C btRE[dT.tOxg to PROPRA-Ty. BUILDING MFORMAT.t09 -E Vi AEStbtXTIZZ C I Cd Unit trypd of 'No:. of Building Cbm Pkstim Desig n gn No 'Redimome Atb& Tab id'i" C*i�tLt'ter .'-..6-4-r�-..'.,d.,.".., -zic-r. 2.; 3 4 Floor , Aqu4ihe4b -Dra;Ens SIGNATURE:: Other. (Specily-) DH 4015 (Pbaplotes, previ.ou editions which may not be 124ad) Incorporate4 649-6.601, FAC Page I of. 4 STATE OF FLORIDA APPLICATION # AP1713212 .DEPARTMENT OF HEALTH PERMIT # 56-SF-2349636 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE1,596627 SITE EVALUATION AND SYSTEMtSPECIFICATION APPLICANT: Treasure Coast Horne Builders LLC CONTRACTOR / AGENT' Nanan Narqen LOT- 12 BLOCK: 132 SUBDIVISION: Lakewood Park ID#1; 1.30ir642-03287'000-1 TO BE COMPLETED BY ENGINEER, HEALTH. DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTRATION NUMBER AIM SIGN AND SEAL EACH PAGE OF SUBMITTAL.. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [X ]-YES ]NO NET USABLE AREA AVAILABLE: 0.27 ACRES TOTAL ESTIMATED SEWAGE. FLOW.- 400 GALLONS PER DAY E RESIDENCES -TABLET OTHER -TABLE 2 AUTHORIZED SEWAGE FLOW;: 404.99 GALLONS PER DAY 1600 GPD/-ACRE7 OR 2500 GPD/ACRE I UNOBSTRUCTED AREA AVAILABLE-: 1000i00SQrT, UNOBSTRUCTED AREA. REWIRED. 1000.00 SQFT BENCHMARK/REFERENCE P0114T LOCATIOR: ELEVATION 07 PROPOSED SYSTEM SITE 1-5.00 1 F2 I [,I ABOVE] / 'BELOW ]. BEXCHM7%RX/REFERENCE POINT THE -MINIbMM' SETBACK WHICH CAN BE MAIN1'A±ftD FROM THE PROPOSED SYSTEM, TO THE FOLLOWING FEATURES SURFACE WATER: FT D-ITCHES/SWALES:: FT N6RMAMLy-.WET- r ]:YES [.X]NO WELLS-: PUBLIC: FT LIMITED USE: FT PRIVATE: 75 FT NON -POTABLE- FT BUILDING FOUNDATIONS: 10 FT -PROPERTY LINES: 1.0 FT POTABLE WATER LIKES: 47 FT SITE SUBJECT TO'FREQUENT FLOODING? 10 YEAR FLOOD ELEVATION FOR SITE:: 0^77 MvnVTT.V QT MW. [ ]YES [ x ]NO 10 YEAR FLOODING? E ]YES - I X] NO] FT C MSL / NGVD I SITE ELEVATION,: FT E MSL / NGVD USDA,S.QIL SERIES: Texture Depth 10 .YR and I OYR 5/1 Sand 2GToA3 10.YR 2/1 Spodit Material 29'. , Ta43 10YR 4/4 Fine Sand. 4311.65.0. 1 6Y-R 514 Fine Sand 5.0:Tb.57 HOLE CAVING, Refusal, V Tb12 e^T '016FMITTM TWWfY0%MrPTnM RTIPP. 9 USDA SOIL SERIES, mullSel,141061pr Texture Depth 10YA 4/1 Loamy Sand. 0 To 6 167; 5 71 Sand 6 to 81 I OYR 6/1 Sand .2.7 To 35 10YR,211 $p6dic Material .35.TQ 45. 10YRA/3 Fine'Sand '46 To 49. 16YRt/3. Fhe:Sand 49ro 5*7 ROLE cAvimi Refusal 57 TO 72 OBSERVED WATER TABLE: 34.0Q INCHES [,ABOVE EXISTING GRADE TYPE: C PERCHED - ESTIMATED: MET SEASON WATER TABLE ELEVATION: 26 INCHES E ABOVE / BELOW I EXISTING GRADE HIGH WATERTABLE VEGETATION: tks tX-INO MOTTLING: E X YXE'S [ ]NO DEPTH:. 26..0.0 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM: SIZING.: -Sand/0.60 DEPTH OF EXCAVATION-: 45 DRAINFIELD CONFIGURATION: [ ] ftENCH. EX.] BED I OTHER. (SPECIFY) 7 REMARKS/ADDITIONAL CRITERIA WSWT deterrqlRed using USDA:WSSand soil borings. I 0YRNIStrlooffig 11p 1 OYR411 6atrix>1 0% With:d . iftuse boundaries Starting at 26" In S131. 9131 IT'.. above -BM. SB2 14" above BM. SITE EVALUATED BY: Ingram, B n (Title: Environmental Specialist 111) (ENVIRONMENTAL HEALTH) DH .4163.5, 08/09 (OVsol.etes previous editio s which may not be used) Incorporated: 64E-6.. 001, FAC INCHES DATE: 09/20/2021 Page 3 of 4 APIMM EID2349636 v 1.0.2 Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved. Property Identification Site Addresm 6504BAYARD Parcel ID: 13014124328 Account#: 172288 Sec/Town/Range:01/34S/39E RD 000-1 Map ID: 13/01 S Zoning: RS-4, Count Use Type: 0000 Jurisdiction:Saint Lgcie_ County Ownership Legal Description Patrick.1Langel LAKEWOOD PARK -UNIT 10- BLK 132 LOT 1.2 (MAP 13/01S) Barbara A Langel (OR 2.763-310) 990 S:Jenkins RD Fort pierce,..FL 34947 CurrentVal ues Historical Values 3-yeas JustlMarket: $11,100 Assessed: $8,961 Year Just/Market Assessed Exemptions Taxable Exemptions: $:0 Taxable: $$,961 2020 $11,100 $8,961 $0 $8,96.1 201.9 $%, 00 $8,147 $0 $8 147 2018 $9,300 $7,407 $0 $7,407 Sale History Date Book/Page Sale Code Deed Grantor Price 0213-2007 276310310 XX0.0 WD Langel-Pat[ickJ $3%000 0i o.lA.9.86 0488 / 2284 XX00 CV $ '000 Primary Building Information Finished Area: of this bug ding: .0 SF Gross: Sketched Area:.0 SF Exterior Data View, Roof Cover.: Roof Structure: Building Type: Year Built: NIA Framer Grade: Effective Year: N/A Primary.Wall: Story. Height: No. Units: 0' Secondary Wall: Interior,Data Bedrooms:. 0 A/C "%i 06/. Electric: Pri.mary.Int Wall:: Fu11.Baths . 0 Heated: %: N/A°!o Heat Type: Avg Hgt/Floor- 0 HalfBaths: 0 Sprinkled'%o.: 0% Heat Fuel: Primary.Floors: Total Areas I :;+ Finished/UnderAir 0 (,SF) -Gross Sketched Area 0 Land Size acres : 0.27 Land Size (SF): 11,826. Total Building Count: 1 Type Special Features and Yard Items Qty Units Year Bit All information is believed. to. be correct at this time, but is subject to -:change and is provided without any warranty. 0 Copyright 2021. Saint Lucie County Property Appraiser. All rights reserved. 80123 2r W z o o v v r+ m x � f1 SU 80' 23' 24' W 3047015 3047024 3047033 3047042 3047051 30470M 3047aw ;xnturo awiwi z z z 80' 2Y 2r W C O, cn N O N 8T 23 25" W X (D O 4 Custom Soil Resource Report St. Lucie County, Florida 4—Arents, 0 to 5 percent slopes Map Unit Setting National map unit symbol. 1 jptx Elevation: 0 to 30 feet Mean annual precipitation: 49 to 58 inches Mean annual air temperature: 70 to 77 degrees F Frost -free period: 350 to 365 days Farmland classification: Not prime farmland Map Unit Composition Arents and similar soils: 90 percent Minor components: 10 percent Estimates are based on observations, descriptions, and transects of the mapunit. Description of Arents Setting Landform: Rises on marine terraces Landform position (three-dimensional): Rise Down -slope shape: Convex Across -slope shape: Linear Parent material. Altered marine deposits Typical profile C1 - 0 to 10 inches: sand C2 - 10 to 51 inches: sand A/Eb - 51 to 80 inches: sand Properties and qualities Slope: 0 to 5 percent Depth to restrictive feature: More than 80 inches Drainage class: Somewhat poorly drained Runoff class: High Capacity of the most limiting layer to transmit water (Ksat): High to very high (5.95 to 19.98 in/hr) Depth to water table: About 18 to 36 inches Frequency of flooding: None Frequency of ponding: None Maximum salinity: Nonsaline to very slightly saline (0.0 to 2.0 mmhos/cm) Sodium adsorption ratio, maximum: 4.0 Available water supply, 0 to 60 inches: Very low (about 3.0 inches) Interpretive groups Land capability classification (irrigated): None specified Land capability classification (nonirrigated): 6s Hydrologic Soil Group: A Forage suitability group: Forage suitability group not assigned (G156BC999FL) Other vegetative classification: Forage suitability group not assigned (G156BC999FL) Hydric soil rating: No 10 Custom Soil Resource Report Minor Components Sanitary landfill Percent of map unit. 5 percent Hydric soil rating: Unranked Canaveral Percent of map unit. 5 percent Landform: Dunes on marine terraces, ridges on marine terraces Landform position (three-dimensional): Interfluve Down -slope shape: Convex Across -slope shape: Linear Other vegetative classification: Forage suitability group not assigned (G156BC999FL) Hydric soil rating: No 21—Lawnwood and Myakka sands Map Unit Setting National map unit symbol. 1jpvg Elevation: 0 to 200 feet Mean annual precipitation: 49 to 58 inches Mean annual air temperature: 70 to 77 degrees F Frost -free period. 350 to 365 days Farmland classification: Farmland of unique importance Map Unit Composition Lawnwood and similar soils: 41 percent Myakka and similar soils: 39 percent Minor components: 20 percent Estimates are based on observations, descriptions, and transects of the mapunit. Description of Lawnwood Setting Landform: Marine terraces on flatwoods Landform position (three-dimensional): Talf Down -slope shape: Linear Across -slope shape: Linear Parent material. Sandy marine deposits Typical profile A - 0 to 8 inches: sand E - 8 to 28 inches: sand Bh 1- 28 to 52 inches: sand Bh2 - 52 to 58 inches: sand C - 58 to 80 inches: sand Properties and qualities Slope: 0 to 2 percent 11 Custom Soil Resource Report Depth to restrictive feature: 10 to 31 inches to ortstein Drainage class: Poorly drained Runoff class. High Capacity of the most limiting layer to transmit water (Ksat): Moderately low to moderately high (0.06 to 0.20 in/hr) Depth to water table: About 6 to 18 inches Frequency of flooding: None Frequency of ponding: None Maximum salinity: Nonsaline to very slightly saline (0.0 to 2.0 mmhos/cm) Sodium adsorption ratio, maximum: 4.0 Available water supply, 0 to 60 inches: Very low (about 0.9 inches) Interpretive groups Land capability classification (irrigated): None specified Land capability classification (nonirrigated): 4w Hydrologic Soil Group: A/D Forage suitability group: Sandy soils on flats of mesic or hydric lowlands (G156BC141 FL) Other vegetative classification: Sandy soils on flats of mesic or hydric lowlands (G156BC141 FL) Hydric soil rating: No Description of Myakka Setting Landform: Flatwoods on marine terraces Landform position (three-dimensional): Talf Down -slope shape: Convex Across -slope shape: Linear Parent material. Sandy marine deposits Typical profile A - 0 to 7 inches: sand E - 7 to 27 inches: sand Bh - 27 to 38 inches: sand C - 38 to 80 inches: sand Properties and qualities Slope: 0 to 2 percent Depth to restrictive feature: More than 80 inches Drainage class: Poorly drained Runoff class: High Capacity of the most limiting layer to transmit water (Ksat): Moderately high to high (0.57 to 5.95 in/hr) Depth to water table: About 6 to 18 inches Frequency of flooding: None Frequency of ponding: None Maximum salinity. Nonsaline to very slightly saline (0.0 to 2.0 mmhos/cm) Sodium adsorption ratio, maximum: 4.0 Available water supply, 0 to 60 inches: Low (about 4.5 inches) Interpretive groups Land capability classification (irrigated): None specified Land capability classification (nonirrigated): 4w Hydrologic Soil Group: A/D Forage suitability group: Sandy soils on flats of mesic or hydric lowlands (G156BC141 FL) 12 Custom Soil Resource Report Other vegetative classification: Sandy soils on flats of mesic or hydric lowlands (G156BC141 FL) Hydric soil rating: No Minor Components Ankona Percent of map unit: 7 percent Landform: Flatwoods on marine terraces Landform position (three-dimensional): Talf Down -slope shape: Convex Across -slope shape: Linear Other vegetative classification: Sandy soils on flats of mesic or hydric lowlands (G156BC141FL) Hydric soil rating: No Electra Percent of map unit: 7 percent Landform: Knolls on marine terraces, rises on marine terraces Landform position (three-dimensional): Interfluve Down -slope shape: Convex Across -slope shape: Linear Other vegetative classification: Sandy soils on rises and knolls of mesic uplands (G156BC131 FL) Hydric soil rating: No Waveland Percent of map unit: 6 percent Landform: Flatwoods on marine terraces Landform position (three-dimensional): Talf Down -slope shape: Convex Across -slope shape: Linear Other vegetative classification: Sandy soils on flats of mesic or hydric lowlands (G156BC141 FL) Hydric soil rating: No 13 . Mission: 'To protect promote:& improve theheallh of all people in Florida through integrated state, county&community retforts. Vision: To be the Healthiest. State in the Nation Ron DeSantis Governor Scott A. Rivkees, MD State Surgeon General Florida Department of Health in St. Lucie Co.unty Conditions for Issuance of Water Well Permits Effective July 24, 2017 • Contact. the Florida Department of, Health in Saint Lucie County (FDOH —St. Lucie) prior to constructing or abandoning any well. a. Cali the FDOH St. 'Lucie Well Line at 772-873-4936or email ;S LG.DOH-WELLS(c_FLHEALTH.GOV b. Provide the following information:. i. Permit number ii. Driller name 'iii. Address iv: Date and time to begin construction/abandonment A minimum of 24 hours' notice is required before constructing any public water supply wells. Please call our main office at 772-873-4931 and, speak with Environmental Health Staff or provide notification by email to SLCDOHMELLS(a,FLHEALTH:.GOV • Submit revisions to permit and%or site map within 48 hours of well construction or abandonment. Florida Department;of'Health-St:Lueie County pivision:of Disease;Control: and'Health Protection Bureau of Environmental Health. Location. 3855.5 US Highway1; Fort Pierce, FL 34982 Mailing: 5160 NW Milner Drive, Port St. Lucie, FL 34983 Phone 772-034631. Fax 772-5954306 FloridaHeatth:gov Accredited. Health Department Public Health Accreditation Board STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT, REPAIR, MODIFY, OR ABANDON A WELL ❑Southwest PLEAS E.FILLOUT ALL APPLICABLE FIELDS 0 Northwest (*Denotes Required Fields Where Applicable) ❑St. Johns River ;R5;S.outh Florida The worerwellcontractorlsraspomibleforewnpleting thfrform and forwardfngtheperinitapplicationtotile []Suwannee River appropriate delegated authority where applicable. CIDEP ❑ Delegated Authority (if Applicable) Treasure Coast Home Bwjldg 2325 SW Neal Road, Port St Lucie, FL 34953 Permit No. 59-32379 Florida Unique ID Stipulations. Required (See Attached) Quad No. Delineation No. C.UP WUP Application No. *Owner, Legal Name if Corporation `Address 'City `State *ZiP Telephone Number 2. 6504 Bayard Road Fort' Pierce FL 34951 -- 'Well Location - Address, Road Name or Number, City 3.1301-612-0328-000-1 12 132. *Parcel ID'No. (PiN) or Alternate Key (Circle One) Lot Block Unit 4. 01 34s 39e St Lucie. Lakewood Park Check 11"62-5240 Yes ❑ No *Section or Land Grant 'Township *Range *County Subdivision 5, Scotts Drilling, Inc. 1121.3 772-48M117 scottsdrilling a@bellsouth.net *Water.Well Contractor 'License Number *Telephone Number E-mail Address 6.5014 Palm Drive Fort Pierce FL 34982 *Water Well Contractor`s Address City State ZIP 7. *Type of Work 0 Construction ❑ Repair ,❑ Modification[] Abandonment - 8, *Number of Proposed Wells. QNE 'ReasonforRepair. Modificalion,orAbandonment 9. •Specify. Intended Uses) of Well(s); n o ; \Y/ C ❑✓ Domestic Landscape Irrigation ❑ Agricultural Irrigation Site Investigations L;-L1 Lf— ❑ Bottled WaterSupply ® Recreation Area Irrigation ❑ Livestock ❑ Monitoring Public Water Supply (Umited UseIDOH) ❑ Nursery irrigation Test Public Water Supply (Community or Non-Community/DEP)❑ CiJimmerciallindustrial Earth=Coupled Geothermal S E P 2 4 2021 Class I Injection ❑ Golf Course Irrigation HVAC Supply HVAC Return Class V Injection: ❑ Recharge ❑ Commercialllndustrial Disposal ❑ Aquifer Storage and Recovery ❑ DrainageF H In St Lucie Count Remediation: ❑ Recovery ❑ Air Sparge ❑Other (oescr@e) E-N I wEi NJ> ALM Other (D.escribe) �c 10.* !stance from Septic System if —< 200 ft: !K, D_ 11. Fac'ilitybescriptionZil.ngle r-amny .KeslOellGC L 12dEstimated Start Date i v—i — iv *Estimated Well Depth 120 ft. `Estimated Casing Depth 100 ft. Primary Casing Diameter 2 . in. Open Hote: From To ft. 14. Estimated Screen Interval: From 100' To 1.20- ft: 15 *Prmary Casing Material: Black Steel Galvanized r/ PVC Stainless Steel Not Cased Other: 16. Secondary Casing: Telescope Casing Liner Surface Casing Diameter in. 17. Secondary Casing. Material: Black Steel Galvanized PVC Stainless Steelnkot 18"Method of Construction. Repair., or Abandonment: Auger Cable Tool Jetted ✓ Sonic Combination (Two or More. Methods) Hand Driven (Well Point, Sand Point) Hydraulic Point (Direct Push) Hprizontal•Drilling Plugged by Approved Method Other (Describe) 19. Proposed Grouting Interval for the Primary, Secondary, an: }itiana Casin From o To 100 Seal Material ( Benfdrit ✓.Neat'Cem Other ) From To Seal Material' ( 'Bentonite Neat Cement Other ) Frorr To Seal Material ( Bentonite. Neat'Cerhent Other ) From To Seal Material( Bentonite NeatCement Other ) 20. lnd(cate total number of existing wells on site. List number of existing unused wells on site 21.1s this well or any existing well orwater ` rawa the owner's .contiguous property covered under a Consumptive/Water Use Permit (CUPfWUP) or CUPIWUP Appi1c9t1on7 Yes', ,/ No . yes, complete the following: CUPNVUP No. District Well ID No. 22. Latitude Long 23.'Data Obtained From: GPS Map Survey Datum: NAD 27 NAD 83 WGS 84 1 horohy tNgify Ural 1. iio bm*wdh IN appllcablo �ulw of Titia 4a Flosga:Adminkitiptiva Code and That a mter t ccNy that i attho armor artho property. that the fntormallon provided,ts acatmto; aad that I am aware of my - . ... _ .. .........,art, n.mt, Statnum-lo fialntain of amoedv abandon Usivall; or, l ceriuy that I om (.12I A� _ a -Zoz r 11213 'License No. 'Signatureb awnerorAgent 'Dale Approval Granted ey_ Issue Daley/wu Expiration Date S_�`I IydrologistApproval DtlWls Fee Received S . _ Receipt No. Check. No. THIS PERMIT IS NOTVALID UNTIL PROPERLY SiGNED BYAN.AUTHORIZED OFFICER OR REPRESENTATIVE OF THE WMD OR DELEGATED AUTHORITY. THE PERMIT SHALL BE AVAILABLE AT THE WELL SiTE DURING ALL CONSTRUCTION, REPAIR, MODIFICATION, OR ABANDONMENT ACTIVITIES. ncn�rA7Z..aa aao nnnm Innnm forbin R9:519 Ann(ii FAR FffpciivP Date' October7. 2010 Page 1 of LEGEND ANC = GUY ANCHOR BM = BENCHMARK (C) :=; CALCULATED b ' I -STANCE CB ZCATCH BASIN Cgs CONCRETE BLOCK STRUCTURE CE, tZOVE-kEDENTRY C-L = CENTERLINE • NC C6 CONCRETE .- cop, = CORNER COVP - COVERED PORCH CS ONek'Ett.5L A D/F DRAIN FIELD DUE. DRAINAGE & UTIL± EASEMENT EL , =ELEVATION Ep. = E6-oF'PXVEMENI FrE = FINISH FLOOR EL81 FMD FOUND ID MENT-1,U.-CATION, ,IP IRON PIPE Ip IROI. ROD , L I kL" -6, -- -INF - RM-ATI-01 LB. UcEN886 b0slw� (M) = MEASURED bx6TAN MNATT =:NAPNETT ---'.0 NAIL AN dH8 = OVERHEAD- ELE'P�'r (0) =. PLAT DISTANCE : = RADIUS R&C = MN Roo a- C& I R/W tO 'd "9' P. F-W--A SF = SQUARE FEET Tp N T 6 t POINT WOOD Ob -FENCE Wm = WATER METER = SPOT ELEVATION (3 = WOOD POWER POLE BST = TELEPHONE RISER LOT 11 40T 2 ,5E 4OR LOTA. N FN.b Val" R-ac LINE. CHART Ll N 90000'00" E 90.00VAM) LOT 1.6 (00WPrED) FFE=.24.58 NO WELL OR SEPTIC INTERFERENCE TION WITHIN 75.' OHE LOTS 14&1:5 (6ccup-TED) SAME OWNER PFE= 23.4-5 OHE- fND:.3/4" TP' Ll I 'I rNb 3/4 N :1+01 DUE 161+-NO ID xF _76' WF)/F e-OR LLJ W OiV TIN TAB BLOCK 1332 I LL u ASEPTIC SYSTEM LOT 11 fI< OTHERS tn (OCCUPIED) LOT 12 --i FFE= 22,96 (.VACANT) cs- —w V-4 :7--go w Go COVP 0 Lij 14.00' 17,08J PROPOSO 0 1 o 0 SINGLE FAMILY 11 RESIDENCE v z Z. Ln 11.01 NO WELL INTERFERENCE b 14,00'25 CE, WITHIN 75' 6'W-b/F-'COA �20.0- W iliV 4'WALK N. PROPO$EC WELL (& WAT SERVICE18, DIF FND S/ to! N GONG FND 5/8" IR NQ ;-0 Mi. l NO ID -0E,ARINGBA-51-5.) N 90-900"00" E' 90.'.00' •(P&M) "reg RIM EL= 20.2 '-W! E 900,.:dd0,(PAM)— o. bO 9WALE ci� [g. 'kil 5WAL Iwo * Z!- ;nl I In t A EP E�P %.?CPO 6' CL CL CL leo 0, 9s E EP . 'o .0 1. EP .'SA YARD ROAD TPSET MN&TT 'P& TP SET MN& NOTD (70' R/W 20'A6PHALT) NO 10 BM EL= 207.7 BA EL= 20;6E I-AbV C33.25 Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved. Property Identification Site Address: 6504 BAYARD Parcel ID- 1301-612-0328=000- Account 4: 172288 Sec/Town/Range: 01/34S/39E RD 1 Map ID: 13/01 S Zoning: RS-4 Count Use Type: 0000 Jurisdiction:, Saint Lucie County OWne_rship Legal Description Patrick J Lang& LAKEVJOOD PARK -UNIT 10- BLK 132. LOT 12 (MAP 13/01 S) (OR Barbara:A Langel 27.63-31.0) 990: S Jenkins RD Fort Pierce,:FL 34947 Current Values Historical Values 3-year Just/Market: $11,100 Assessed: $8,961 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $8,961 2020 $1.1,1.00 $8961 $0 $8,961 201.9 $9,800 $%147 $0 $8,147 2018 $9 300 $7,407 0. $7,407 Sale History Date Book/Page Sale Code Deed Grantor Price 02=13-2097 2763 f 03.1.0 XX00 WD Langel.Patrick J $30,000 01-01;4986 0488/2284 M00 CV $553000 Pri.m:ary, Building Information I iiuslied Atea of This building: 0 SF Gross Sketched Area: 0 SF Exterior Data View: Roof'Cover: Roof Structure: Building Type: Year Built: N/A Frame Grade: Effective Year: N/A Primary WaII: Story Height: No. Units: 0 Secondary Wall: Interior Data Bedrooms: 0 A/C %: 0% Electric: Primary IpE Wall:. Full Baths: 0 Heated %: N/A%o Heat Type: Avg Hgt/Floor: 0 Half Baths; 0 Sprinkled %5 0% Heat::Fuel- Primary Floors. �'�� Total Areas ��Y+ +rr;:�� • yr Finished/Under Air (SF): 0 Gross Sketched Area. 0' (SF). Land Size (acres): 0.27 Land Size (SF); 11„826 Total.'Building Count: 1 Type Special Features and Yard Jtems Qty Units Year Blt All information is believedao be correct at this:fhno, but.is subJect'to charge.and.is provided. withoutanywarranty. Copyright 2021 SaintLucie County Property Appraiser. All rights reserved. St... Lucie County Health Department 6160 NW! Milner Dr Port Saint Lucie, FL 34983 HEAIT& PAYING ON: #:56-SP-2349636 'b1LL.D0C*.56BIb-5508082 c0NSTRpqT10NAPPL!CAT10N #..AP17132.12 RECEIVED FROM: NarianNaroen. . AMOUNT PAID: "$660.00 PAYMENT FORK CREDIT CARD '000747 PAYMENT DATE: 0811-6/1021 MAIL TO: (Treasure Coast Home: Builders LLG) FAG I LITY NAME PROPERTY LOGAT10N.. 6504- Bayard Ad Lot: 12.. .1 Block: 132 i . _m Property !D.- 1301-412-0 PQ=i ------------ fEXPLANATIQN or DESCRIPTION; QUANTITY FEE 126 - 08TDS Construction 8y8torn inspection Research ,Fee ee 1 $ 5.00 Su.rcharge (All) -1 mOSTD8- NOW Vor-mif 6 Uroh.Eirg6 -I -,-Q8TQS,Construction' Appllo;A.on Arid Plan Review,New 1.23 - 08TDS %G0hstUctid.n. Sft& Evaluation -12-6 - OSTDS Construction Permit (N*eW or Mod, Amendment) 127 08TDS. C&nttrUbtlon -System lnsppcfion '1-53 - QSTEYS.'C-.onstruefibn..Rel-n.5pec.tfati -1 -Well Cofttrutflon RECEIVED 8Y-Ad' MWC 1 $ 45000 1 $. 100.00 .$ 106.00 $ 115.00 $ 55.00 $ 75400 $ '50.00 $- 115.00 AUDIT CONTROLNO. 56-PID-5148970