HomeMy WebLinkAboutAPPROVED HEALTH DEPT PERMIT AND SURVEYSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Jose & Weelda Pinto
PROPERTY ADDRESS: 3505 S Indian River Dr Fort Pierce, FL 34982
LOT:
BLOCK:
PROPERTY ID #: 2426-311-0004-000-7
SUBDIVISION:
PERMIT #:56-SF-2429266
APPLICATION #: AP1770640
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT # : PR1723403
[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 [ 1,350 ] GALLONS / GPD Septic 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 [ 967 ] SQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [X] BED [ ]
N
F LOCATION OF BENCHMARK: Site BM Nall in tree, NW Of house
I ELEVATION OF PROPOSED SYSTEM SITE [ 44.00][ INCHES FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 74.00][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D E
O
T
H
E
R
ILL REQUIRED: L U.UU ] INCHES EXCAVATION REQUIRED: L J 1NCa1C A
The system is sized for 6 bedrooms with a maximum occupancy of 12 persons (2 per bedroom), for a total estimated flow of
580 gpd.
Bottom of drainfield not to exceed 30" below finished grade.
SPECIFICATIONS BY: Brian J InAram TITLE: Environmental Specialist III
APPROVED BY: + �TITLE: Environmental Specialist III St. Lucie CHD
Brian J Iiycjram
DATE ISSUED: 02/01/2022 EXPIRATION DATE: 08/01/2023
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 AP1770640 SE1639800
STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT,
REPAIR, MODIFY, OR
ABANDON A WELL
0 SouthWest
❑ Northwest
PLEASE FILL OUT ALL APPLICABLE FIELDS
('Denotes Required Fields Where Applicable)
❑SL ,Johns River
South Florida
The waterwelleonrractorisresponsibleforcompleting
❑ 8 River
Ills form turd lmwarding thepernlit application to the
uwannee
trpprolrriaredebtgatcdouthortlywlrcreapplictible.
❑ DEP
❑ Delegated Authority (if Applicable)
Permit No. 59-32794
Florida Unique ID
Permit Stipulations Required (See Attached)
62-524 Quad No. Delineation No.
CUPNVUP Application No.
s• a
1• MKMM Rental Properties 790 SE Ablett Lane Port St Lucie, FI 34984
'Owner, Legal Name if Corporation "Address 'City 'State *ZIP Telephone Number
2. 3505 S Indian River Drive Ft Pierce, F134982
"Well Location - Address, Road Name or Number, City
3.2426-311-0004-000-7
"Parcel ID No. (PIN) or Alternate Key (Circle One) Lot Block Unit
4. 26 35S 40E St Lucie Check if 62-524:❑ Yes 0 No
"Section or Land Grant *Township, "Range "County Subdivision
5. James Paul Tyson 11352 954-818-4269 down thehole2att.net
'Water Well Contractor 'License Number "Telephone Number E-mail Address
6. PO BOX 881496 Port St. Lucie Fi 34988
'Water Well Contra&tor's Address City State ZiP
7. "Type of Work: ;onstruction ❑ Repair ❑ Modif{cation❑✓ Abandonment
8. 'Number of Proposed Wells 1 'Reason for Repair. Modificatlon, or Abandonment
9, 'Specify Intended Use(s) of.Well(s): Date tam
Domestic Landscape Irrigation [] Agricultural Irrigation ❑ Site Investigations [�-ti! r u ll
Bottled Water Supply (],Recreation Area Irrigation ❑ Livestock ❑ Monitoring
Public Water Supply (Limited Use/DOH) ❑ Nursery Irrigation n Test
Public Water Supply (Community or Non-Community/DEP)❑ Commercial/Industrial 0 Earth -Coupled Geothermal FEB� r1�,�?
Class I Injection ❑ Golf Course Irrigation 8 HVAC Supply r C U 0
HVAC Return
,lass V injection: ❑ Recharge ❑ Commercial/industrial Disposal ❑ Aquifer Storage and Recovery ❑ Drainage
elmediation: ❑ Recovery ❑ Air Sparge ❑ Other (Desenbe)
1 fi II�>r7r �_tdfd®I(tyOUn
Other (DeScnbe) --tall
10.'Distance from Septic System if S 200 ft. 10't' 11. Facility Description Proposed Residence 12. Estimated Start Date ASA
13,"Estimated Well Depth 120 ft. `Estimated Casing Depth 100 ft. Primary Casing Diameter 4 in, Open Hole: From To' ft.
14, Estimated Screen Interval: From 100 To 120 ft. .�)
15.'Primary Casing Material: Black Steel Galvanized 49;' C Stainless Steel
Not Cased Other:
16. Secondary Casing: Telescope Casing Liner Surface Casing Diameter in.
17. Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel Other)
18_'Method of Construction, Repair, or Abandonment: Auger Cable Tool Jetted Sonic
Combination (Two or More Methods) Hand Driven (Well Point, Sand Point) Hydraulic dint (Direct Push)
Horizontal Drilling Plugged by Approved Method Other (oascdbo)
19. Proposed Grouting Interval for the Primary. Secondary, and t net Casing:
From o To 95 Beef Material ( Bentonite Gent Other )
From To Seal Material ( Bentonite Neat Cement Other )
From To Seal Material ( Bentonite Neat Cement Other )
From To Seal Material ( Bentonite Neat Cement Other )
20. Indicate total number of existing wells on sited�@� �1 List number of existing unused wells on site 0
21,°Is this well or any existing well or water wit f}� I n the owner's contiguous properly covered under a ConsumptivelWater Use Permit (CUP/WUP)
or CUP/WUP Application? Yes \ If yes, complete the following: C NUUP No. District Well ID No.
22. Latitude Longitude
23. Data Obtained From: GPS Map Survey
I hrnelrr aelply hint I WO eunadf with ran appliealdo rules of Till, 40, Florid. AdndNnl,otli,o Cade, and thni nwnlar
Me panrdt at aldlldal archarpo Parnell. It 000,1M. has bum in, WIN be oblalnad plor to noam—camam et wall
emrstnldian. I fwlher eaN/y that erN Inhxnu,pmt provided bt thy, eppLwvinn In acaurale imd that I will aM:dn
nacoasary appoml in" (pdwal, slam, ttr bcal porornmanM, If app3wHa. l allana to p,ovlrio n wall
carrotation report to pl/ll ;jIlln 30 days ally wrafpapMl of Out wwdreoion, rapbr, alodrnainon, or
rdwudtarnrnnt.apltlRr{fod 4114%pamil, m the pewit asocial m wfdshunror occur: flea.
1
11352
'Signature of Contractor
'License No.
Approval Granted By
Fee Received s
Receipt No.
Datum: NAD 27 NAD 83 WGS 84
I carllly that I am Ilia error or the In patty; that the Informal- provldcd Is accuroto, and that I ern aware of m /
•aparulta7lGas urrdar Chaptnr 373. Florida Statutes; fa molnraln or propoity ut..d.n 06 well: a,1 ceMfy that I an,
Ihu oo al for fhe minor, pint mho InfarmWion prmidod to ocetuWe, and Near I hwo Interred p,o aM,ar of their
rr.;ponxlNpllar. nc aNlyd nfwwn. Owner wrLSatilr; to atlowinp polsanncl of This NMD of Odapatcd llwhairy narx3
la the vrop slto d the, eery, plop, Miller. modlncapolh a abdndonnaht auplodzed by iris Parent.
f ^/-../-12/17/21
'Signature of owner or Agent 'Date
Issue Dale 2' r rk"tt- Expiration pate W I Hydrologist Approval
If i
Check No.
lmtlai:
THIS PERMIT IS NOT VALID UNTIL PROPERLY SIGNED BY AN AUTHORIZED OFFICER OR REPRESENTATIVE OF THE WMO OR DELEGATED AUTHORITY, THE
PERMIT SHALL BE AVAILABLE AT THE WELL SITE DURING ALL CONSTRUCTION, REPAIR, MODIFICATION, OR ABANDONMENT ACTIVITIES.
DEP Form: 62-532,000(1) Incorporated in 62-532.400(i), F,A.C. Effective Date; Oclobcr 7, 2010 Page 1 of 2
LEGAL DESCRIPTION:
BEGINNING AT A POINT 286.00 FEET SOUTH OF THE NORTHWEST
CORNER OF THE NORTHEAST QUARTER OF THE SOUTHWEST QUARTER
OF SECTION 26, TOWNSHIP 35 SOUTH, RANGE 40 EAST, ST. LUCIE
11w • 141aw � N fi000-W- W 87"" I"n") COUNTY, FLORIDA; THENCE RUN SOUTH 95.25 FEET TO A POINT;
Folnf of a:or. THENCE RUN EAST, PARALLEL WITH THE EAST AND WEST QUARTER
B.ghniny SECTION LINE, TO THE WEST SHORE OF THE INDIAN RIVER, THENCE IN
+ o FDOH in St. Lucie County A NORTHWESTERLY DIRECTION, MEANDERING THE WEST SHORE OF THE
o Environmental Health INDIAN RIVER, TO A POINT DUE EAST OF THE POINT OF BEGINNING:
Site Plan Apprcved for Constructipn THENCE TURN AND RUN WEST, PARALLEL WITH THE SAID QUARTER
hs9s�u� �`L°° ,6° SECTION LINE, A DISTANCE OF 2580 FEET TO THE POINT OF BEGINNING.
Savanna
Preserve ' Supe,*des All Previous Site PloS for s ' EXCEPTING THEREFROM THE RIGHTS OF WAY OF THE FLORIDA EAST
ow-ffweTm) rep "r OSTDS •z fo6 &Well#593 COAST RAILWAY AND SOUTH INDIAN RIVER DRIVE (STATE ROAD 707).
41, Ee�°l 0 4+ Gate: S -31
Rev' awe LOT AREA: 214,327 Sq. Ft; 4.92 Acreef
y am, [ Etrur — N go �,�� E �2 STREET ADDRESS: 3505 SOUTH INDIAN RIVER DRIVE, FORT PIERCE,
FLORIDA 32982.
PARCEL IDENnnCATION MIHBER
242e-311-0003-OoO-O
°
N WOO'00' W 378.4X R°sh of 0■°r1 �'° ,°� Mar ybC�N [P9°00' ■+/-
s EXISTING CON[RE fE DRI�EWAr
a (TO DE DEuCLs+Eo)
i s
PROPOSM 16
°° ¢° snoa ■ \ t / •� , ° S"� CONCRETE DRIVEWAY
\ p
100 X (TYPICAL) xA° °"Om wIDPDSEn a X � "
/.\ ONE -STONY - 69� '�l^l_,
PROPOSED SEPTICTANKB 2 ��
a nm DRAIN FIELD
PROPO
LLD I 1 �- - - SIZE TO SE DETERMINED BY S' '`-
,rumml $ HEALTH DEPARTMENT .1
C.
yq. f3 q2 �d'
11 000 00 E 782.4? ,a,■ , o T
NOTE: NO LIVE WELLS OR SEPTICT TANKS FOUND IAlITHIN 100' M so am [ N00' +/-
ao Im •�cr
PARCEL IDDITIRCATION NW OM
SURVEYORS' NOTES: 242e-311-OD05-ODO-4
1. BEARINGS SHOWN HEREON ARE BASED ON THE NORTH LINE
OF THE SUBJECT PROPERTY AND BEARS N 90'00'00' E.
2. THE EXPECTED USE OF THE SURVEY AND MAP IS FOR
CONSTRUCTION PERMITTING.
3. ALL DISTANCES AND BEARINGS ARE AS FIELD MEASURED AND
ARE COINCIDENT WITH 'PLAT' AND DESCRIPTION DATA UNLESS
OTHERWISE NOTED.
4. THIS DRAWING IS NOT VALID WITHOUT THE SIGNATURE AND
ORIGINAL USED SEAL OF A FLORIDA LICENSED SURVEYOR &
MAPPER-
5. THIS SURVEY IS BASED UPON A DESCRIPTION FURNISHED BY
THE CLIENT. THERE HAS BEEN NO EXTENSIVE SEARCH OF THE
PUBLIC RECORDS BY THIS OFFICE.
6. NO ATTEMPT HAS BEEN MADE TO LOCATE UNDERGROUND
IMPROVEMENTS.
7. ADDRIONS OR DELETIONS TO SURVEY MAPS OR REPORTS BY
OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED WITHOUT
WRITTEN CONSENT OF THE SIGNING PARTY OR PARTIES.
8. PROPERTY HEREON LOCATED IN FLOOD ZONE 'X' PER F.I.R.M.
12111CO193K, DATED 2-19-20.
9. THE TRAVERSE CLOSURE FOR THE SUBJECT PROPERTY EXCEEDS
1:10,000'.
10. PARCEL IDENTIFICATION NUMBER: 2426-311-0004-000-7.
11. ALL MEASUREMENTS ARE IN ACCORDANCE WITH THE UNITED
STATES STANDARD IN FEET AND DECIMALS,
12. ORIGINAL BENCH MARK - NATIONAL GEODETIC SURVEY,
DESIGNATION P 23, DYNAMIC HEIGHT 10.221 (meters), 33,53 (feet).
CERTIFIED TO: JOSE PINTO & WEELDA PINTO
CERTIFICATION:
I HEREBY CERTIFY THAT THE SURVEY PRESENTED HEREON WAS PERFORMED UNDER
MY SUPERVISION AND IT COMPUES NTH THE STANDARDS OF PRACTICE AS SET
FORTH BY THE FLORIDA BOARD OF SURVEYORS & MAPPERS IN CHAPTER
5J-17.050 - 17.052 OF THE FLORIDA ADMINISTRATIVE CODE, PURSUANT TO
SECTION 472.027, FLORIDA STATUTES, AND FURTHER THAT THERE ARE NO VISIBLE,
ABOVE GROUND ENCROACHMENTS UNLESS SHOWN OR NOTED. `.
STEVEN D. MARSHALL LS6376