HomeMy WebLinkAboutOSTDS NewPERMIT #: 56-SF-I 775713
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Daniel Wauters
PROPERTY ADDRESS: 1115 Brocksmith Rd Fort Pierce, FL 34945
LOT: BLOCK: SUBDIVISION:
PROPERTY ID #: 2317-211-0001-000-4
APPLICATION #:AP1298512
DATE PAID•
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1069517
[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; I
1,050 ]
GALLONS / GPD SeDtic new
CAPACITY
A' I
]
GALLONS / GPD N/A
CAPACITY
N; I
]
GALLONS GREASE INTERCEPTOR CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K I
]
GALLONS DOSING TANK CAPACITY [
]GALLONS @[ ]DOSES PER 24 HRS #Pumps
D [ 667 ] SQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED DO MOUND [ ]
CONFIGURATION: [ ] TRENCH [x] BED [ ]-
N
F LOCATION OF BENCHMARK: top of oral
I ELEVATION OF PROPOSED SYSTEM SITE
L BOTTOM OF DRAINFIELD TO BE
I
D
qI
I
T
H
knot in oak S of
[ 48.00][ INCHES FT ][ABOVE /LBELONji BENCHMARK/REFERENCE POINT
[ 37.00][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
.L" MQUIRED: [29.001 INCHES EXCAVATION REQUIRED: [ ] INCHES
The system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of
400 gpd.
The licensed contractor installing the system is responsible for installing the minimum category of tank in accordancafth
S. 64E-6.013(3)(f), FAC.
;CIFICATIONS BY: Brian J Ingram TITLE: Environmental Specialist,
'ROVED BY: Brian J Ing � YLITLE: Environmental Specialist II St. LUCie CHD
•
E ISSUED: 07/20/2017 EXPIRATION DATE: 01/20/2019
4016, 08/09 (Obsoletes all previous editions which maY not be used)
orporated: 64E-6.003, PAC Page 1 of 3
v 1.1 A A P1298512 S£1042357
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.
STATE OF FLORIDA
DEPARTNUNT OF HEALTH
ONSITE- SEWAGE TREATTMNT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
ASIPLICATION FOR. -
NOW System j ] Existing System
[ ] Repair I 7 Abandonment
-bg,���78
PERMIT NO.,5)�7 -7
DATE PAID:
FEE PAID:
RECEIPT a:
[ ] Holding Tank I ] Innovative
I ] Temporary I ]
APPLICANT:
AGENT: S R .J'PV'�: G �I�i'�i�C L ���' TELEPHONE: p.
MAILING- ADDRESS;* CACAlLG
TO BE CONPLETED 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 Ck ATID OR
PLATTED (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS.
PROPERTY INFORMATION g
LOT: BLOCK: SUBDIVISION: �-'eq-va, PLATTED:
PROPERTY ID ,#: 2- %� I �QOO —600' y ZONING: I/M OR EQU2VALENT: I Z' / N ]
PROPERTY SIZE: t� ACRES WATER SUPPLY: P< PRIPATE PUBLIC,[ ]<=2000GPD j 1>2000GPD
IS SEWER AVAILABLE AS PER 381-0065, FS? [ Y /ON ] -DISTANCE TO SERER: JV�4 FT
PROPERTY ADDRESS:
DIRECTIONS TO PROPERTY: n } yemf1'P agA-e ` u1b nn ��kSmt ! /Z_�_Tb - 1115, B*eweL/6y--A;-rA
BUILDING INFORMATION
Unit, Type of
No Establishment
1 M �
I2 '
3
4
[ ] Floor/Equipment Drains
,A4 0 n ,%
SIGNATURE:
RESIDENTIAL I ] COMbT±RCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
— Al_ 2 2 55'
I ] Other ( Specify)
DATE: ` I
DH 4015, 08/O'9 (Obsoletes previous editions which may not be used)-
Incornorated 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
LICANT: Daniel Wauters
TRACTOR / AGENT: ASHTON SEPTIC TANKS, INC.
BLOCK:
APPLICATION # AP1298512
PERMIT # 56-SF-1775713
DOCUMENT # SE1041357
SUBDIVISION: ID#:2317-211-0001-000-4
O BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE
GISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
tTY SIZE CONFORMS TO SITE PLAN: [X]YES [ ]NO NET USABLE AREA AVAILABLE:, 5.00 ACRES
,ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ]
:IZED SEWAGE FLOW: 7500.00 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
'RUCTED AREA AVAILABLE: 1000.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1000.00 SQFT
REFERENCE POINT LOCATION: top of oranc
OF PROPOSED SYSTEM SITE 48.00 [
knot in oak S of sy.
/ FT I [ ABOVE /I BELOW I] BENCHMARK/REFERENCE POINT
MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
ACE WATER: 100 FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [ ]NO
.S: PUBLIC: FT LIMITED USE: FT PRIVATE: 75 FT NON -POTABLE: FT
DING FOUNDATIONS: 5 FT PROPERTY LINES: 50 FT POTABLE WATER LINES: 50 FT
ITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO]
0 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
lnTT. PROFTT.F. TWFARMATTAW RTTF. 1 CnTT. PR[1FTT.F. TWFARMATTM RTTF. 9
i
USDA SOIL SERIES:Pineda sand
Munsell #/Color Texture
Depth
10YR 5%2
Sand
0 To 20
10YR 6/,8
CMN/PRM RF
13 To 33
10YR 7l4
Sand
20 To 33
1 OYR 5%1
Sandy Clay Loam
33 To 50
10YR 5/1
Sandy Loam
50 To 57
HOLE CAVING
Refusal
57 To 72
USDA SOIL SERIES:Pineda sand
Munsell #/Color Texture
Depth
10YR 5/2
Sand
0 To 19
10YR 6/8
CMN/PRM RF
19 To 33
10YR 7/4
Sand
19 To 33
10YR 5/1
Sandy Clay Loam
33 To 50
10YR 5/1
Sandy Loam
50 To•54
HOLE CAVING
Refusal
54 To 72
VED WATER TABLE. 19.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
kTED WET SEASON WATER TABLE ELEVATION: 18 INCHES ( ABOVE / BELOW ] X�STING GRADE
WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH r�3;00 INCHES
TEXTURE/LOADING RATE FOR SYSTEM SIZING:
Sand/0.60 DEPTH OF EXCAVATION(,;- INCHES
?HELD CONFIGURATION: [ ] TRENCH [X ] BED [ ] OTHER (SPECIFY) _`��
3MARKS/ADDITIONAL CRITERIA
VT determined suing USDA WSS and soil borings.
26/8 CMN PROM RFs mottling in 10YR5/2 matrix >2% starting at 13" in SB2.
47" below BM. SB2 48" below BM.
rE EVIALUATED BY:
Ingram, Briar6 itle: Environmental Specialist 11) (ENVIRONMENTAL HEALTH)
4015,,08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC
AP1298512 EID1775713
DATE: 07/20/2017
Page 3 of 4
v 1.0.2
STATE OF FLORIDA PEWJ TAPPLICATION TO GONSTRUC1,
REEPAIR, ANODIFX OR ARAINDON A WELL
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