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HomeMy WebLinkAboutAPPLICATION FOR CONSTRUCTION PERMITI � AN 1F`I R B art Ludo CCU AIV 9 STATE OF FLORIDA F. ...• DEPARTMENT OF HEALTH p ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: PERMIT NO. DATE PAID: FEE PAID: «— RECEIPT #: r [X ] New System [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ J Abandonment [ ] Temporary [ ] 4 APPLICANT: Standard Pacific of Florida GP, Inc. AGENT: The MilCor Group, Inc. TELEPHONE: 772-223-8850 MAILING ADDRESS: 6526 S Kanner Highway, Stuart, FL 34997 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: 9 BLOCK: SUBDIVISION: Riverbend PLATTED: PROPERTY ID #: 4425-703-0014-000-6 ZONING: PUD I/M OR EQUIVALENT: [ Y / N ] PROPERTY SIZE: 0.5 ACRES WATER SUPPLY: [ ] PRIVATE UBLIC [X ]<=2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y / ® ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: 3030 NW Radcliffe Way, St. Lucie County, FL DIRECTIONS TO PROPERTY:East on Becker Rd for approximately 2.5 miles to Gilson Rd. Then north on Gilson Rd. for approximately a mile. Then East on NW Radcliff Way. . BUILDING INFORMATION Unit Type of No Establishment 1 Single Family 2 3 4 [ ] Floor SIGNATURE: [ X] RESIDENTIAL [ ] COMMERCIAL No. of Building Commercial/Institutional System Design Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC 5 4,086 tbka4ns [ /]/\ Other (Specify) p j DATE: I % %, ° 1 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 SPECIFICATIONS "LOT: BLOCK: SUBDIVISION: d�\�C Y K-t- PROPERTY ID #: 4q 2A-VrMl4-tom ^(D [Section/Township/Parcel No. or Tax ID Number] PERMIT #. 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: [ ] YES [ ] NO NET USABLE A LE: ACRES TOTAL ESTIMATED SEWAGE FLOW: GALLONS PER DAY �S ENCES- LE 1/OT - E21 AUTHORIZED SEWAGE FLOW: GALLONS PER DAY D/AC 500 GPD/AC UNOBSTRUCTED AREA AVAILABLE: SQFT UNOBSTRUCTED AREA REQUI SQFj' BENCHMARK/REFERENCE POINT LOCATION:_ ELEVATION OF PROPOSED SYSTEM SITE IS BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES/SWALES: FT NORMALLY WET? [ ] YES [ ] NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT BUILDING FOUNDATIONS: FT PROPERTY LINES: FT POTABLE WATER LINES: FT SITE SUBJECT TO FREQUENT FLOODING: [ ] X S [�/f NO 10 YEAR FLOODING? [ ] YES ,C�] NO 10 YEAR FLOOD ELEVATION FOR SITE: � FT MSL/NGVD SITE ELEVATION: �.7,Z FT MSL NGVD SOIL FROYILK JANNX.LuDd .b"1TL• 1 TEXTURE DEPTH % ( • TO TO p TO' od A- TO UTO TO TO TO TO USDA SOIL SERIES: t Vq7V 5 �-60— SOIL PROFILE INFORMATION SITE 1 MUNSELL #/COLOR TEXTURE v(4 'titL 5 Gi/I L9 L � r� l✓ C4 USDA SOIL SERIES : !ii ✓ , n1 TO TO TO TO TO TO TO OBSERVED WATER TABLE: G C) INCHES [ABOVE / EL ] EXISTING GRADE. TYPE: [PERCHED / ATT] ESTIMATED WET SEASON WATER TABLE ELEVATION: e> INCHES [ABOVE / LO EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ] YES V NO b30TTLING: [1j� S [ ] NO DEPTH: 2-6 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: 5 /- DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [ TRENCH [ ] BED [ ] PTHER (SPECIFY) REMARKS /ADDITIf1NAL CRITERTA : S d S 1.4 50 (_ ---, leo— a—,6 I c r "3TE' SITE EVALUATED BY: f �V �A— DH 4015, 08/09 (obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 Of 4 REPRESENTATIVE AUTHORIZATION Riverbend Subdivision Please be advised that the undersigned has authorized the following person(s) to act on their behalf in seeking approval for the above referenced application: Witness: Melissa G. Corbett, P.E. The Milcor Group, Inc. 6526 South Kanner Highway #236 Stuart; Florida 34997 (772)223-8850 C (�� t-) < k1C1J1-1'C-Z- By: J t Name Print Name, ACKNOWLEDGEMENT STATE OF - COUNTY OF vr,Q n �/ The foregoing was acknowledged before me this (� day of �" " bAj'&`^b'Q' 20 ( by Q (`' CyOk, , and K] is personally known to me or [ ] has produced as identification. 612 Notary Stamp Notary Public SIVAN SHACHAR ."4'iN, AT MY COMMISSION #FF007026 c°' '•.. f of f.�u (407) 398 0153 EXPIRES April 10.2017 FlorldoNOWYSecv —Ccm APPLICANT'S NAME: Standard Pacific of Florida GP, Inc. LEGAL DESCRIPTION: Riverbend (PB 67-36) - Lot 9 i r�.��$` E 7� 4 Ayv r..r--�a'-'-^¢¢a.�-i, r � � k �; � v}tc 4-ry -z'� ?•�sr'3sc#�' 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. docs/forms/septics/ScpticApppPagc207 'Property Card Page 1 of 1 Site Address: 3030 NW Parcel ID: 4425-703-0014- Account #: 176830 Sec/Town/Range: Radcliffe WAY 000-6 25/37S/40E Map ID: 44/25S Zoning: AR-1 Use Type: 0000 Jurisdiction: Saint Lucie County Ownership Legal Description Standard Pacific Of Florida RIVERBEND (PB 67-36)- LOT 9 15360 Barranca Pkwy Irvine, CA 33609 • Current Values Historical Values 3-year Just/Market: $59,100 Assessed: $59,100 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $59,100 2015 $59,100 $59,100 $0 $59,100 2014 $66,000 $66,000 $0 $66,000 2013 $66,100 $66,100 $0 $66,100 Sale History Date Book/Page Sale Code Deed Grantor Price 11-26-2012 3460 / 0152 0205 SP Stuart Property Holdings Ltd, $7,000,000 10-03-1996 1039 / 1107 00 WD Virginia G Atterbury $3,000,000 03-27-1996 1006 / 0858 01 PB $0 Total Areas Finished/Under Air (SF): Gross Area (SF): Land Size (acres): Land Size (SF): Total Building Count: Special Features and Yard Items Type Qty Units Year Blt This information is believed to be correct at this time but it is subject to change and is not warranted. © Copyright 2015 Saint Lucie County Property Appraiser. All rights reserved. http://www.paslc.org/RECard/ 12/3/2015 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS New . APPLICANT: (Standard Pacific of Florida GP, Inc) PROPERTY ADDRESS: 3030 NW Radcliffe Way Palm City, FL 34990 LOT: 9 BLOCK: SUBDIVISION PROPERTY ID #: 4425-703-0014-000-6 PERMIT #: 66-SF-I 646927 APPLICATION # : AP 1214954 DATE PAID: FEE PAID• RECEIPT #: DOCUMENT #: PR997282 Riverbend [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, E.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 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 [ 650 ] SQUARE FEET SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [x] FILLED [ ] MOUND [ ] I CONFIGURATION: [x] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: pop nail in CWB near center of lot "elev 7.39" I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L MW 0 T H E R [ 16.001 FT I [I ABOVE BELOW] BENCHMARK/REFERENCE POINT [ 14.00111 INCHES FT ] [ABOVE BELOW ]BENCHMARK/REFERENCE POINT 1LL Z1'MWUJr'Zjj. l lb.UUJ INCHES EXCAVATION REQUIRED: [ 60.001 INCHES The system is sized for 5 bedrooms with a maximum occupancy of 10 persons (2 per bedroom), for a total estimated flow of 520 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. SPECIFICATIONS BY: Brian Davis TITLE: Master Septic Tank Contractor APPROVED BY: TITLE: Environmental Specialist I St. Lucie CHD Brian J ngram DATE ISSUED: 12/10/2015 EXPIRATION DATE: 06/10/201 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC v 1.1.4 AP1214954 SE979221 7 Page 1 of 3 w 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 # A02, Tallahassee, Florida 32399-1703. The Agency Clerk's facsimile number is 850-410-1448. 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.