HomeMy WebLinkAboutVOIDSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR:
APPLICANT: Celestino Ponce
PROPERTY ADDRESS: TBD Bi
LOT: BLOCK:
OSTDS New
er Rd Fort Pierce, FL 34945
0.1*d , '.
PROPERTY ID #: 2309-122-0000-000-9
PERMIT # 56-SF-1841839
APPLICATION # : AP 1340968
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1115987
[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 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 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 0( ]DOSES PER 24 HRS #Pumps [ j
D [ 667 j SQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [Xj BED [ ]
N _ \
F LOCATION OF BENCHMARK: Site BM Red capped set IRC N Of house
I ELEVATION OF PROPOSED SYSTEM SITE y:ad[� 5A0 j1 INCHES; (F, ]HOVE BELOW BENCHMARK/REFERENCE POINT
,
E BOTTOM OF DRAINFIELD TO BE ))00 t s sL �'
[•, 8. 1.NCH41 ]1',ABOVE BELOW BENCHMARK/REFERENCE POINT
{ y
D FILL REQUIRED: [20.00] INCHES CAVAT.ION REQUIRED: L ] INCHES
The system is sized for 4 bedrooms with a maximum cupancy of 8 persons (2 per bedroom), for a total estimated flow of
O 400 gpd.
T The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with
H s. 64E-6.013(3)(0, FAC.
E
R
SPECIFICATIONS BY: Brian J Ingrate TITLE: Environmental Specialist II
APPROVED BY: /y TOTE: Environmental Specialist II St. Lucie CHD
Brian J Ingram
DATE ISSUED: 05/08/2018 EXPIRATION DATE: 11/0812019.
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Pag 1 f 3
v 1.1.4 AP1340969 SE1076313
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 recei trof this order. The address of the
asa .,� �a
Agency Clerk is 4052 Bald Cypress Way, BIN A-02 Tel huassee, Florida 32399. The Agency
Clerk's facsimile number is 850-413-8743. �.,5i
Mediation is not available as za � Iterh iVe a edy...t`,
�,,�-,r.
Your failure to submit a petitt�forari�ag wi.; in21 days from receipt of this order will
t� y, .
constitute a waiver of your right to anr'a` r inist�ative hearirig'. and this order shall become a 'final
order'. c Y f
Should this order become a final=,6rder, 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.
4r STATE OF FLORIDA
7`' DEPARTMENT OF HEALTH
'p ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[v/] New System [ l Existing System [ ] Holding Tank
[ ] Repair L l Abandonment [ ] Temporary
APPLICANT: CELESTINO FUENTES PONCE:
AGENT: Alexander J. Piazza PSM, Inc. :1 ,.
MAILING ADDRESS: 619 SW Biltmore Street, Port � ,�uck;Y1 ida�49
PERMIT NO. S
DATE PAID:
FEE PAID:
RECEIPT # : r�
cv •
[ ] Innovative
[ l
�-6 1 !1 L1L4,)'fib--
TELEPHONE: 772-340-7770
2-
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: BLOCK: SUBDIVISION: NOT PLATTED PLATTED:
PROPERTY ID #: 2309-122-0000-000-9 ZONING: R I/M OR EQUIVALENT: [ No ]
PROPERTY SIZE: 12.10 ACRES WATER SUPPLY: [,/I PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: BERGER ROAD, Fort Pierce, Florida 34945
DIRECTIONS TO PROPERTY: SEE MAP
BUILDING INFORMATION
Unit Type of
No Establishment
1 RESIDENCE
EVI RESIDENTIAL L ] ••:COMMERCIAL
No. of Building, Commerciaj\/Institutional System Design
Bedrooms Area Sqft Table .,�`_`ha ter 64E-6, FAC
rrg
2 W
3
4
[ ] Floor/Equipment Drains [ ,/ ] Other (Specify) GARBAGE GRINDERS / DISPOSALS
SIGNATURE:
DATE: 4-12-18
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Celestino Ponce
CONTRACTOR / AGENT:
LOT:
Alexander J. Piazza PSM, Inc
BLOCK:
APPLICATION # AP1340968
PERMIT # 56-SF-1841839
DOCUMENT # SE1076313
SUBDIVISION: ID# : 2309-122-0000-000-9
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: [
TOTAL ESTIMATED SEWAGE FLOW: 400
AUTHORIZED SEWAGE FLOW: 18150.00
UNOBSTRUCTED AREA AVAILABLE: 1000.00
BENCHMARK/REFERENCE POINT LOCATION: Site BM Red
ELEVATION OF PROPOSED SYSTEM SITE 5.00 if
p `'.'
r 1WT USABLE AREA AVAILABLE : 12.10 ACRES
k
3R [AYttS✓�F2ESIDENCES-TABLE1
/ OTHER -TABLE 2 ]
i• Y j
Rf]I)AY?"''
R
"1500 GPD/ACRE OR 2500 GPD/ACRE ]
�J UNOBST1Wd1tED AREA REQUIRED: 1000.00 SQFT
)ped set IRC N of house
HES / FT ] [ ABOVE / BELOW ] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: 200 FT DITCHES/SWALES: 30 FT NORMALLY WET: [ ]YES [X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 85 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 75 FT POTABLE WATER LINES: 60 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
SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2
USDA SOIL SERIES:Nettles sand
Munsell #/Color Texture
Depth
10YR 4/1
Sand
0 TO 9
10YR 5/2
Sand
9 To 34
10YR 6/1
Sand
22 To 34
10YR 3/3
Sand
34 To 39
10YR 513
Loamy Sand
39 To 51
5Y 5/3
Loamy Sand
51 To 59
5GY 5/1
Sand
59 To 72
USDA SOIL SERIES:Nettles sand
Munsell #/Color Texture
Depth
10YR 4/1
Sand
0 To 10
10YR 5/2
Sand
10 To 35
10YR 6/2
Sand
25 To 35
10YR 3/3
Sand
35 To 41
10YR 5/3
Sandy Loam
41 To 51
Loamy Sand
51 To 61
• 5GY 5/1
iF ;�
Sand
61 To 72
(C9
6
OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / BEkO�T, I Lrk: E, ISTING"yrGRADE TYPE:
ESTIMATED WET SEASON WATER TABLE ELEVATION: 22 �MNCHi ' [ ABOVE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO
[ PERCHED / APPARENT ]
EXISTING GRADE
DEPTH: 22.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.60 DEPTH OF EXCAVATION: INCHES
DRAINFIELD CONFIGURATION: [ ] TRENCH [X] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA
WSWT determined using USDA WSS and soil borings.
10YR6/1 stripping in 10YR5/2 matrix >10% with diffuse boundaries starting at 22" in SB1.
SB1 5" below BM. SB2 4" below BM.
SITE EVALUATED BY:
Ingram, Brian (Title$nvironmental Specialist II) (ENVIRONMENTAL HEALTH)
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC
DATE: 05/01/2018
Page 3 of 4
AP1340968 EID1841839 v 1.0.2
STATE OF FLORIDA
DEPARTMENT OF HEALTH
g ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
PERMIT #.'-S#C- 1 Y141637
APPLICANT: CELESTINO FUENTES PONCE , AGENT: Alexander J. Piazza PSM, Inc.
LOT: BLOCK: I SUBDIVISION: NOT PLATTED
PROPERTY ID # : 2309-122-0000-000-9 I 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: I✓] YES jAl NNQQ� ]
TOTAL ESTIMATED SEWAGE FLOW: 666 4��1O S.�� PER
AUTHORIZED SEWAGE FLOW:LONS R
r •a
UNOBSTRUCTED AREA AVAILABLE: 1000 � i,N ` 1SQ 'T hd
BENCHMARK/REFERENCE POINT LOCATION:
ELEVATION OF PROPOSED SYSTEM SITE IS 34 s [ Nbi fEs / F'r" ]
IBLE AREA AVAILABLE: ACRES
[ RESIDENCES -TABLE 1/OTHER-TABLE 2 ]
[1500 GPD/ACRE OR 2500„GPD/ACRE ]
PED AREA REQUIRED: 1000 SQFT
/BELOW] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK_WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER:100 FT
DITCHES/SWALES:15 FT
NORMALLY WET? [ I YES I✓]
NO
WELLS: PU13LIC:200 FT
LIMITED USE:100 FT PRIVATE:75
FT NON—POTABLE:100
FT
BUILDING FOUNDATIONS:5
FT PROPERTY LINES:10 FT
POTABLE WATER LINES:"
FT
C
SITE SUBJECT TO FREQUENT
FLOODING: I ] YES [✓] NO 10
YEAR FLOODING? I ] YES j✓]
NO
10 YEAR FLOOD ELEVATION
FOR SITE: FT MSL/NGVD SITE
ELEVATION: FT MSL/NGVD
SOIL PROFILE INFORMATION SITE 1
MUNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
SOIL PROFILE INFORMATION SITE 2
MUNSELL #/COLOR TEXTURE DEPTH
5:
lv
TO
TO
TO
TO
TO
TO
TO
mn
OBSERVED WATER TABLE:40+ INCHES [BELOW q 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:
DRAINFIELD CONFIGURATION: [�/] TRENCH [ ] BED
REMARKS/ADDITIONAL CRITERIA:
SITE EVALUATED BY:
DEPTH OF EXCAVATION: INCHES
] OTHER (SPECIFY)
DATE: 4-12-18
di ri DH 4015, 12/11 (Obsoletes previous a tion:� w ich may not be used) Incorporated: 64E-6.001, FAC Page 3 0£ 4
APPLICANT'S NAME:
CELESTINO FUENTES PONCE
LEGAL DESCRIPTION: NOT PLATTED PIP# 2309-122-0000-000-9
I 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 SURVEYOR OR ENGINEER.
Alexander oN11��5lo 'dbylAl d&,4 u
ou=A01427E0000016581EE3C9600001
981,m=NexanderfPlaa
ia77a Da le: 2018.13.1808:43:04 -05'DO'
CERTIFIED BY:
FLORIDA PROFESSIONAL NO.: 6330
DATE: 12/18/18 JOB NO.: 14-1918
docs/ Forms/septics/SepticAppp Page207