HomeMy WebLinkAboutSewage Construction PermitR;Ei:;!' _ D JUL 13 717
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: (Hang Blue Builders)
PROPERTY ADDRESS: TBD Spring Hill Dr Jensen Beach, FL 34957
PERMIT #:66-SF-1768472
APPLICATION # : AP 1294020
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1066460
LOT: 6 BLOCK: 1 SUBDIVISION: Spring Hill
[SECTION, TOWNSHIP, RANGE, PARCEL'NUMBER]
PROPERTY ID #: 4504604-0013-0007 [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 [ 900 ] GALLONS / GPD SeDtiC 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 [ 375 ] SQUARE FEET
R [ ] SQUARE FEET
A TYPE SYSTEM: [x]
I CONFIGURATION: [x]
N
F LOCATION OF BENCHMARK:
Drainfield new SYSTEM
N/A SYSTEM
STANDARD [ ] FILLED [ ] MOUND [ ]
TRENCH [ ] BED [ ]
Site BM
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
Di
0
T
H
E
R
int X CL of Rd. Center of pn
[ 32.00 ] [ INCHES I FT ]
BELOW] BENCHMARK/REFERENCE POINT
2.00 ][ INCHE3 FT ][ABOVE BELOW] BENCHMARK/REFERENCE POINT
PILL REQUIRED: [ U.UU] INCHES EXCAVATION REQUIRED: [ J LNuhE5
The system Is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
300 gpd.
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.
NO WSWr. BDF NOT TO BE > 30" BELOW GRADE
0 Y
I L w hm' U
SPECIFICATIONS BY: Brian J Ingram TIC: Environmental Specialist II
a '
APPROVED BY: TITLE: Environmental Specialist II St. Lucie CHD
Brian J I
DATE ISSUED: 06/23/2017 EXPIRATION DATE: 12/23/2018
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1294020 SE1038509
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.
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
PAYING ON: PERMIT* 56=SF-1768472 BILL Doc #:56-BID-3445466 CONSTRUCTION APPLICATION #: AP1294020
RECEIVED FROM: Atlantic Land Design AMOUNT PAID: $ 515.00
PAYMENT FORM: CREDIT CARD PAYMENT DATE: 06/07/2017
MAIL TO: (Harry Blue Builders)
FACILITY NAME:
PROPERTY LOCATION:
TBD Spring Hill Dr
Jensen Beach, FL 34957
6 1
Lot: Block:
Property ID: 4504-604-0013-0007
EXPLANATION or DESCRIPTION:
QUANTITY
FEE
-1 - OSTDS Construction Application and Plan Review,New
1
$
100.00
123 - OSTDS Construction Site Evaluation
1
$
115.00
126 - OSTDS Construction Permit (New or Mod, Amendment)
1
$
55.00
127 - OSTDS Construction System Inspection
1
$
75.00
128 - OSTDS Construction System Inspection Research Fee
1
$
5.00
133 - OSTDS Construction Reinspection
1
$
50.00
-1 - Surcharge (All)
1
$
15.00
-1 - OSTDS New Permit Surcharge
1
$
100.00
RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-3262859
J
STATE OF FLORIDA APPLICATION # . AP1294020
DEPARTMENT OF HEALTH PERMIT # 56-SF-1768472
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
DOCUMENT # SE1038509
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Harry Blue Builders
CONTRACTOR / AGENT: Atlantic Land Design
LOT: 6 BLOCK: 1
SUBDIVISION: Spring Hill ID#: 4504-604-0013-0007
TO BE COMPLETED BY ENGINEER, _HEALTH DEPARTMENT EMPLOYEE, OR 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: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.33 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 495.01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 563.00 SQFT UNOBSTRUCTED AREA REQUIRED: 563.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION:
ELEVATION OF PROPOSED SYSTEM SITE
Site BM orange Paint X CL of Rd. Center of
32.00 [ INCHES / FT ] I ABOVE / BELOW ] BENCHMARK/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 [X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 75 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 10 FT
SITE SUBJECT TO FREQUENT FLOODING?
10 YEAR FLOOD ELEVATION FOR SITE:
Tffl/1L1TT T. T1.TLV1D/�.f7 TTAL7 QTTL_ 1
[ ]YES [X]NO
10 YEAR FLOODING? [ ]YES [X]NO]
FT [ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
t,l1T]VT TI~ QTTv 13
USDA SOIL SERIES:St.
Munsell #/Color
Lucie sand
Texture
Depth
10YR 3/1
Sand
0 To 9
10YR 4/1
Sand_
9 To 13
10YR 511
Sand
13 To 17
10YR 6/1
Sand
17 To 25
10YR 711
Sand
25 To 72
USDA SOIL SERIES:St.
Munsell #/Color
Lucie sand
Texture
Depth
10YR 3/1
Sand
0 To 6
10YR 4/1
Sand
6 To 14
10YR 5/1
Sand
14 To 17
10YR 6/1
Sand
17 To 23
10YR 711
Sand
23 To 72
OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE:
ESTIMATED WET SEASON WATER TABLE ELEVATION: 72 INCHES [ ABOVE / BELOW ]
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO
[ PERCHED / APPARENT ]
EXISTING GRADE
DEPTH: 72,00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION:
DRAINFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA
,WT determined using USDA WSS, soil borings, and area topography. Heavily sloping property.
WSWT indicators. WSWT below 72"
1 42" above BM. SB2 32" above BM.
SITE EVALUATED BY:
Ingram, Brla�itle: Environmental Specialist II) (ENVIRONMENTAL HEALTH)
DR 4015, 08/09 (obsoletes previous editions which may not be used) Incorporated: 64E-6,001, FAC
INCHES
DATE: 06/14/2017
Page 3 of 4
AP1294020 EID1768472 v 1.0.2
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
PERMIT #.�% ".SF- !16?Y-7
W SITE EVALUATION AND SYSTEM SPECIFICATIONS Xt-�SN�
APPLICANT:.-- �C.CrVIULI&/[de AGENT: •lV'i-lG�r�i/ l/��� ir�a4 G� /
LOT;, BLOCK: SUBDIVISION: ��')�.) LJ ' �4)
on
PROPERTY ID #: 'E0q 6A 0013 660 .7 [Section/Town�rrs��higyp--/Parcel No. or Tax ID Number]
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE,OR 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: [j YES [ ] NO NET USABLE AREA AVAILABLE: 0,3 3 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 4L GALLONS PER DAY [RESIDENCES -TABLE 1/0THER-TABLE23
AUTHORIZED SEWAGE FLOW: GALLONS PER DAY [1500 GPD/ACRE OR 2500 GPD/ACRE]
UNOBSTRUCTED AREA AVAILABLE: SQFT UNOBSTRUCTED AREA REQUIRED: SQFT
BENCHMARK/REFERENCE POINT LOCATION:_ (-- r42OAd
ELEVATION OF PROPOSED SYSTEM SITE IS [INCHES
BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER:16-0_FT DITCHES/SWALES: /C FT NORMALLY WET? [ l YES [ ] NO
WELLS: PUBLIC: Z6'a FT . LIMITED USE: 1 0C; FT PRIVATE:C, FT NON -POTABLE: 5`y�� FT
BUILDING FOUNDATIONS: -Is -FT PROPERTY LINES:' c FT POTABLE WATER LINES:fp'Jgg! FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES r Y NO 10 YEAR FLOODING? I l YES 7°�'I]ENO
10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD
ova.i, rAuz'J-J-m tlyr'V1te7AT:LVN S=TE 1
MUNSELL #/COLOR TEXTURE
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
SVJ.L YLCVL''"M INFORMATION SITE 2
MUNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
OBSERVED WATER TABLE: INCHES [ABOVE / BELOW] EXISTING GRADE. TYPE:[PERCHED / APPARENT]
ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [ABOVE / BELOW] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO MOTTLING: [ ] YES [ ] NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: INCHES
DRAINFIELD CONFIGURATION: [ l TRENCH [ ] BED I ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA:
SITE EVALUATED BY: DATE:
DH 4015, 08/09 (obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 Of 4
A t.:V ] -7-zS q
STATE OF FLORIDA PERMIT
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: /
'•��c' SYSTEM RECEIPT #:
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
.New System [ ] Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair 1 Abandonment [ ] Temporary [ ]
APPLICANT: ]\IG►
AGENT: �yyt �! �+�j�' -6 TELEPHONE: `?'7250) -lflgO
MAILING ADDRESS: TDgoy �J �/• �j���� ��J� rj f � ��� �,Ot�
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: v
BLOCK:
SUBDIVISION:
5��17 ��y'�l
Sdd�Aj�
1- '
S7�4PLATTED:
jqs V
PROPERTY ID
#: •-1 �O�
404
001 J e9&,) %
ZONING:
I/M OR
EQUIVALENT: [
Y / N ]
PROPERTY SIZE: 0,33 ACRES WATER SUPPLY: ] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FSY [ Y / T�J DISTANCE TO SEWER: Ala FT
PROPERTY ADDRESS:-TBb • �j��j' All Dbgu
DIRECTIONS TO PROPERTY: l410 4e
BUILDING INFORMATION [Po RESIDENTIAL [ ] COMMERCIAL
Unit Type of No. of Building Commercial/Institutional System Design
No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, PAC
1
c
2
3
4
[ ] Floor/Equipment Drains [ -1 Other (Specify)
SIGNATURE: DATE: Zi`Zi
DH 4015, 08/09 fetes previous editions which may not be used)
Incorporated 64E-5:001,,FAC Page 1 of 4