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Home My WebLink AboutOSTDS NEWSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Keith & Brandi Pearson PROPERTY ADDRESS: TBD Jorgensen Rd Fort Pierce, FL 34981 LOT: 81 BLOCK: SUBDIVISION: White City PROPERTY ID #: 3403-502-0144-030-7 PERMIT #:66-SF-1807597 APPLICATION #: AP1318542 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1086721 [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 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 [ 667 ] SQUARE FEET Drainfield new SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [x] MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: site BM NiD CL of Rd SW property corner I ELEVATION OF PROPOSED SYSTEM SITE [ 23.00][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 18.001 INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L 0 T H E R 'ILL REQUIRED: [13.00] 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 400 gpd. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E-6.013(3)(0, FAC. BY: Brian J I am TITLE: �� Environmental Specialist II APPROVED BY: TITLE: Environmental Specialist II DATE ISSUED: DH 4016, 08/09 Incorporated: Brian J In 12/20/2017 (Obsoletes all previous editions which may not be used) 64E-6.003, FAC AP1318542 St. Lucie CHD EXPIRATION DATE: 06/20/2019 sliit Copy 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 5150 NW Milner Dr Port Saint Lucie, FL 34983 PAYING ON: PERMIT #: 56-SF-1807597 BILL ooc #:56-BID-3639811 CONSTRUCTION APPLICATION #: AP1318542 RECEIVED FROM: Trefelner Construcion Inc. AMOUNT PAID: $ 515.00 PAYMENT FORM: CHECK 1532 PAYMENT DATE: 12/07/2017 MAIL TO: Keith & Brand! Pearson FACILITY NAME: PROPERTY LOCATION: TBD Jorgensen Rd Fort Pierce, FL 34981 Lot: 81 Block: Property ID: 3403-502-0144-030-7 EXPLANATION or DESCRIPTION: QUANTITY FEE 128 - OSTDS Construction System Inspection Research Fee 1 $ 5.00 -1 - Surcharge (All) 1 $ 15.00 -1 - OSTDS New Permit Surcharge 1 $ 100.00 -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 $ 75.00 133 - OSTDS Construction Reinspection 1 $ 50.00 RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-3448885 dE STATE OF FLORIDA PERMIT N0.5G-W -1 ?075 P 7 DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID. 650 SYSTEM RECEIPT #: ^,V-j5r32- we APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [V/] New System [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT: Keith & Brandi Pearson AGENT: Trefelner Construction Inc. James Trefelner TELEPHONE: 772-201-9833 MAILING ADDRESS: 1760 Copenhaver Rd. Ft. Pierce, F1 34945 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: 81 BLOCK: SUBDIVISION: White City Subdivision PLATTED: 1901 1 PROPERTY ID #: 3403-502-0144-030-7 ZONING: AR-1 I/M OR EQUIVALENT: [ No ] PROPERTY SIZE: 2.35 ACRES WATER SUPPLY: [,/] PRIVATE PUBLIC [ ]<=2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: Jorgensen Road DIRECTIONS TO PROPERTY: see map on survey BUILDING INFORMATION [✓] RESIDENTIAL [ ] COMMERCIAL Unit Type of No. of Building Commercial/Institutional System Design No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC 1 Residence 3 2321 2 3 4 [ ] Floor/Equipment Drains [ ✓ ] Other (Specify) Garbage Grinders/Disposal SIGNATURE : I.,, DATE: 12n117 DH 4015, 08/0Y (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC Page 1 of 4