HomeMy WebLinkAboutSewage OSTDS NewRECEIVED AUG 01 2017 -
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Johnny Rambo
PROPERTY ADDRESS: 2300 Canoe Creek Ln Fort Pierce, FL 34981
LOT: 7 BLOCK:
PROPERTY ID #: 3404-701-0007-000-0
SUBDIVISION:
PERMIT #: 56-SF-I 770999
APPLICATION #: AP1295581
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1067000
[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 [ 900 ] GALLONS / GPD SeDtiC 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 Drainfield SYSTEM
R [ ] SQUARE FEET
N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD
[ ] FILLED [X] MOUND [ ]
I CONFIGURATION: [XI TRENCH
[ ] BED [ ]
N
F LOCATION OF BENCHMARK: North end of property @ west PL
I ELEVATION OF PROPOSED SYSTEM SITE
[ 2.00 ][ INCHES
FT ][ ABOVE
BELOW] BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE
[ 14.001[ INCHES
FT ][ ABOVE
BELOW] BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [30.003 INCHES
EXCAVATION REQUIRED: [
] INCHES
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
O 300 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)(f), FAC.
E
S{ L ��,,iR ._ ....�. `!�/0
SPECIFICATIONS B/Y:/lI Brian Davis �/ TITLE: Master Septic Tank Contractor
APPROVED BY: V f / ! TITLE: Env. Sup 11 St. Lucie CHD
V Victor Facon'tr-
DATE ISSUED: 06/26/2017 EXPIRATION DATE: 12/28/2018
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
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
HEALTH5150 NW Milner Dr Port Saint Lucie, FL 34983
PAYING ON: PERMIT #: 56-SF-1770999 BILL Doc #:56-BID-3451976 CONSTRUCTION APPLICATION #: AP1295581
RECEIVED FROM: Brian Davis Septic & Backhoe Services AMOUNT PAID: $ 400.00
PAYMENT FORM: CREDIT CARD PAYMENT DATE: 06/19/2017
MAIL TO: Johnny Rambo
FACILITY NAME:
PROPERTY LOCATION:
2300 Canoe Creek Ln
Fort Pierce, FL 34981
7
Lot: Block:
Property ID: 3404-701-0007-000-0
EXPLANATION or DESCRIPTION:
QUANTITY
FEE
-1 - OSTDS Construction Application and Plan Review,New
1
$
100.00
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-3276982
STATE OF FLORIDA
DEPARTMENT OF HEALTH
p; ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[X 7 New S st
PERMIT NO. !� � ��•% t%�I
DATE PAID; (j - j Ct • / 1
FEE PAID.-
RECEIPT:
Y em [ ] Existing System [ ] Holding Tank [ ] Innovative
[ I Repair C ] Abandonment [ 7 Temporary [ ]
APPLICANT: Johnny S Rambo
AGENT: Brian. Davis Septic & Backhoe Services
TELEPHONE: 7 72 . 5 71. 82 0 0
MAILING ADDRESS: P-O Box 99, Fellsmere, FL 32948
TO BE COMPLETED BY APPLICANT OR'APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BECONSTRUCTEDBY 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: 7 BLOCK: N/A SUBDIVISION: CANOE CREEK
PLATTED: V ` -L-
PROPERTY ID #: 3404-101-0007-000-0 ZONING: R I/M OR EQUIVALENT: [ Y / to
PROPERTY SIZE:. 1.13 ACRES WATER SUPPLY: [ PRIVATE PUBLIC [ 3c=2000GPD [ 1>2000GPD
11
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y / DISTANCE TO SEWER: �Crt�'•FT
PROPERTY ADDRESS: 2300 Canoe Creek Ln, Fort Pierce, FL 34981
DIRECTIONS TO PROPERTY: Merge on 95,Take FL-70 Exit,Turn L on Okeechobee Rd,
Turn R on S Jenkins Rd,Take the 1st L on Edwards Rd,Turn R on Selvitz Rd,
Turn L on Midway Rd,Turn R on S 25th St,Turn L on Canod Creek Ln,2300 Canoe
Creek Ln is on the Left
BUILDING INFORMATION [�l RESIDENTIAL [ j COMMERCIAL
Unit Type of
No Establishment
1
House
FA
3
a
No. OP Building Commercial/Institutional System Design
Bedrooms Area Saft Table 1, Chanter 64E-6 PAC
3 11899
[ ] Floor/Equipment Drains [ ] Other (Specify)
SIGNATURE! � DATE:
DR 4015, 08/09 (Obsoletes p=evious editions which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
STATE OF FLORIDA PERMIT #.7 g'�) D 4 Y
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT .AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
APPLICANT: Johnny s Rambo AGENT: Brian Davis Septic & Backhoe
LOT- '7 BLOCK: N/A SUBDIVISION: CANOE .CREEK
PROPERTY ID #: 3404-701-.0007-000-0 [Section/Township/Parcel No. or Tax ID Number]
TO BE COMPLETED By ENGINEER, HEALTH DEPARTEMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINNEERS
MUST PROVIDE REGISTRATION NUMSER'AND 6IGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS_
PROPERTY SIZE CONFORMS TO SITE PLAN: [ ] YES [ I
TOTAL ESTIMATED SEWAGE FLOW: _jc�J GALLONS
AUTHORIZED SEWAGE FLOW: GALLONS
UNOBSTRUCTED AREA AVAILABLE: /SQFT
BENCHMARK/REFERENCE POINT LOCATION: '�GL�j
ELEVATION OF PROPOSED SYSTEM SITE ISM_ CHE:
10 NET USAB AVAILABLE: r•L � r ACRES
PER DAY RESIDENCES -TABLE' OTHER-TABLE23
PER DAY [].500 OR 500 GP/D/ACRE]
UNOBSTRUCTED AREA REQUIRED:_ �!� � SQFT
�FTI�E/ELOW] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PIFPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER:=LL�FT DITCHES/S[yTAI,E9 • �( 1FT NORMALLY WET? [ j YES
WELLS: PIIBLTC: FT LIMITED USE: I FT PRIVATE: �y NO
BUILDING FOUNDATIONS: —� 7 / FT NON-POTABLE:��FT
FT PROPERTY LINES: 3 FT POTABLE WATER LINES:FT
SITE SUBJECT TO FREQUENT FLOODING: I 1 �XE� [(jj NO
10 YEAR FLOOD ELEVATION FOR SITE: ` 10 YEAR FLOODING? ��[!] YES �•] No
1A&- FT MSL/NGVD SITE ELEVATION; ((S(-FT MSL/NGVD
b"L PROFILE INFORMATION SITE 1
MUNSELL #COLOR TEXTURE DEPTH SOIL PROFILE INFORMATION SITE 2
/ L�/ MUNSELL #/COLOR TEXTURE DEPTH
/ 06
ZTO r °� S a , _
TO O S-. , TO Z
9iSTo%Z�.5 TO %L
TO TO
TO TO
TO TO
TO TO
USDA SOIL SERIES: - �jL K�1C1 W�¢ ?�j j� TO
USDA SOIL SERIES: ! ��-iy5ry
OBSERVED WATER TABLE:`! Z INCHES [ABOVE / DLO' EXISTING GRADE,
ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [ABOi
HIGH WATER TABLE VEGETATION: [ ] YES [% -- NO TIL
�jr ING. Aj YES
SOIL TEXTURE/LOADINGRATE F.QR. SYSTEM SIZING: 5C(�
DRAINFIELD CONFIGURATION: CAI T E H DEPTH OF
� [ ] BE%' [ ] p OT ER (SPECII
REMARKS /ADDI ZONAL CRITERIA: �I.� /�j .`% S t �f Gam- 11r t�
SITE EVALUATED BY: Y( `¢-1i
52tG Lq
TYPE:,PERCHED / ppAgE ]
EXISTING GRADE
{ O DEPTH:_ --[INCHES
%� s
EXCAVATION: v INCHES
DATE: c [ J
]x 4015, 08/09 (Obsoletes ,previous editions which may not be used) Incorporated: 64E•6.001, FAC r
Page 3 of 4
Property hard
Page 1 of 2
Michelle Franklin, CFA -- Saint Lucie County Properly Appraiser -- All rights reserved.
Property Identification
Site Address: 2300 Canoe Parcel ID: 3404-701-0007- Account #: 39884 Sec/Town/Range:
Creek LN 000-0 04/36S/40E
Map ID: 34/04S Zoning: RS-2 Use Type: 0000 Jurisdiction: Saint Lucie
County
Ownership
Legal Description
Johnny S Rambo
CANOE CREEK LOT 7 AND BEG AT NW COR LOT 7, TH
124 Family CIR
ELY ALG N LI OF SD LOT 7 271 FT TO NE COR OF SD
Benton, LA 71006-9320
LOT7, TH NLY 50 FT, TH ELY TO W SHOREOF N FORK
OF ST LUCIE RIV, TH MEANDER SD W SHORE NLY TO
PT ON AN EXTENSION OF S LI OF RIVER HAMMOCK
S/D, TH WLY ON SD EXT OF SD S LI TO A PT LYG 100 FT
N OF NE COR OF SD LOT 7, TH CONT WLY ALG S LI OF
RIVER HAMMOCK S/D 271 FT, TH SLY 100 FT TO NW
COR SD LOT 7 AND POB (MAP 34/04S) (1.13 AC) (OR
3970-1284)
Current Values
Historical Values 3-year
Just/Market: $75,200
Assessed:
$67,980 Year Just/Market Assessed Exemptions Taxable
Exemptions: $0
Taxable:
$67,980 2016 $75,200 $67,980 $0 $67,980
2015 $61,800 $61,800 $0 $61,800
2014 $61,800 $61,800 $0 $61,800
Sale History
Date
Book/Page
Sale Code Deed Grantor Price
03-03-2017
3970 / 1284
0001 WD Hardie Carol B $75,000
06-01-1981
0357 / 0220
XX02 CV $32,500
03-01-1979
0305 / 0162
XX00 CV $15,900
Primary Building Information
Finished Area of this building: 0 SF
Gross Area of this building: 0 SF
View:
Year Built: N/A
Primary Wall:
Bedrooms: 0
Full Baths: 0
Half Baths: 0
Type
Exterior Data
Roof Cover:
Roof Structure:
Building Type:
Frame:
Grade:
Effective Year: 2014
Story Height:
No. Units: 0
Secondary Wall:
Interior Data
A/C %: 0%
Electric:
Primary Int Wall:
Heated %: N/A%
Heat Type:
Avg Hgt/Floor: 0
Sprinkled %: 0%
Heat Fuel:
Primary Floors:
Total Areas
Finished/UnderAir 0
(SF):
r.t
Gross Area (SF): 0
Land Size (acres): 1.13
Land Size (SF): 49,222.8
Total Building Count: 1
Special Features and Yard Items
Qty Units Year Blt
tp://www.pasle.org/RECard/ 6/23/2017
STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT, _ J^01 1
REPAIR, MODII=Y, OR ABANDON A WELL Permit No.
❑ Southwest Florida Unique 10
PLEASE FILL OUT ALLAPPLICABLE FIELDS ❑ Nouhwest (`Denotes Required Fields Where Applicable) Permit Stipulations Required (See Attached)
❑ St. Johns River
Mouth Florida fie wnrewdltconrrdinris thePernitble for oppliccorntothg
rhhformandrvnw/drng[heperrnrlappGeurionronce 62-524 Quad Na. Delineation No.
❑Suwannee River appmpraredekTatedaurhorltyrhij cnpplicahrr,
❑ DEP CUPPJYUP Application No.
❑Delegated Authority (If Applicable)
!
1.
`owner, Legal Na a if Corporation dress lty 'Slat 'ZIP Telephone Number
2. r 7 ane,-
II Location - Address, Road Name or Numb
3. '
*Parcel'ID' (PIN} orAl(erw to Key (CirCCJJe~QQne) J Lot Block unit
4.
�j n r 1 Check if 82-524:❑ YesNo
ecti&9nd 'Township ange "County Subdfvf.
• ,, a//teed
"License Number Telephone �jumb�� n n E-m�alJl Address
6.
ZIP
'Water Well Contractors Address City
state
7. -Type of Work: 0 Construction [] Repair ❑ Modificatlon[] Abandonment
8. "Number of Proposed Wells 'Reason tor Repair. Modifu Milan, arAhandotvnant
ate temp
9. 'Specify Intended Use(s) of WeI s):
HDdhiestic Landscape Irrigation Agricultural irrigation Site Investigations
Bottled Water Supply 0 Recreation Area Irrigation ❑ Livestock y Monitoring
Public Water Supply (Limited UsbIDOH) Nursery Irrigation ❑ Test.
Public Water -Supply (Community or Non-CommunitylDEP) Co mmerciaVlnduslrial Earth -Coupled Geothermal
Class l injection Golf Course irrigation HVAC Supply
H HVAC Return
Class V injection: ❑ Recharge ❑ CommercfaVlndustrial Disposal ❑ Aquifer Storage and Recovery ❑ Drainage
Remediation: ❑ Recovery ❑ Air Sparge ❑ Other (Desalco) Official Use Only
❑ Other toestxioe)
10.'Distance from Septic System If 5 200 ft. 11. Facili DescrlptIon 12. Estimated Start Date
13 -Estimated Well Depth q�Lt. "Estimated Casing Depth it. Pr4a3
sing Diameter in. Open Hole: From To R
14. Estimated Screen Interval: From 4To -ta R.
15.JPrimary Casing Material: Black Steel Galvanized PVC Stainless Steel alp ?
Not Cased Other:
16, Secdndary Casing: Telescope Casing Uner Surface Casing prameter In_
17. Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel Other
18.•Method of Construction, Repair, or Abandonment: Auger Cable Tool Jetted 21hi E11.17
Rotary
Combination (Two or More Methods) Hand Driven (Well Point, Sand Point) Hydraulic Dint (Direct Push)
-Horizontal Drilling Plugged by Approved Method Other. (Ddacliber
19. Proposed Grouting Interval for the Primary, Secondary. and Additional Casing: n St LUCID County
From To Seal Material( Bentonite eatcgm Other ENVIRONMENTALHE,,i_.'1-1
From To Seal Material ( Bentonite a n Other )
From To Seal Material ( Bentonite Neat Cement Other )
From To Seal Material ( Bentonite Neat•Cement Other )
20. Indfcate.total number of existing wells on site List number of existing unused wells on site
21.1Is:this well or any-exisfin well orwater wit , awal a the owners contiguous property covered under a ConsumptiveMater Use Permit (CUPIWUP)
"ut CUP1VVUP Application Yes No Eyes. complete the following: CUPJ UP No. District Well ID No.
22. Latitude t ude
23..D2ta Obtained Front: GPS ap Survey Datum: NAD 27 NAD 83 WG5 84
r hacby ofK4 lierI%G 00 iY�„tllfhe apprlawla culei crTdle- rnotWa Pd wative Code, and lhala holm swpo a t�1�a �af vti aripFl�'�wtm to mala do w PmPaih ly Ns 'Val; "1 cc�idry ad�ut I am
uap,rmli to ueYldrndw9M pvnit•anaedad, has lwen ort, Ib tia ro cammanaament at imD pa!t
a"poWa,,. rraa,ar txaIryu.,r.rmwnttdc.hog�achOrI ,pprk:o«,r..�vrma aaeer,u wiz abwn me a6cmfarlh ,.r. Imainwmwuaaaa+��aRa .ana marina�emtoa�ed uw o•+�Kaa,ar'
nawssmvswal SamalFwNava SIAM arroccl ocvernnnn•a, IraPPb�a. I Moran m ptavida anry lespoasc%iW M. abava.O .MPr,4:asam onnil altNa WMD or byteeabdnit. gMMce:a
' tamplaUon rpaRtoOgDishkfniWn30da}nataraompl�onofNaeonstradlm.lepaU.rtamAwaaa:w
to Ae WcKA19 Inp •mmWdron. rapnL, mad Ibn,an n,lsru,wnlatMadxed aY dd. pttmt.
a NauYtMdzad by tidy psrmL or m$n,pksduLlntilcbwerawnf@aL V' ,n
*Sig a to.. .Contractor Life No. 'Sip o OwnerorAgent 'Date
App•, Gtanbd By �'e Issue Data �{= . ! Expiration Dale�BV,�.. HydrolDpistApproval IAaak
Fee Recefved'3 Receipt No. Check No.
THIS PERMIT IS NOT VALID UNTIL PROPERLY SIGNED BY AN AUTHORIZED OFFICER OR REPRESENTATIVE OF THE WMD OR DELEGATED AUTHORITY. THE
PERMIT SHALLSE AVAILABLE AT THE WELL SITE DURING ALI:CONSTRUCTiON. REPAIR, MODIFICATION. -OR ASANDONMENT ACTIVITIES,
DEP Form: 62-532,900(t) Incorporated in U2-532AQ (1), F.A.C. ElfWfvd Date: October7, 2010 Page I oil
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