HomeMy WebLinkAboutPROPOSED SEPTIC SYSTEM SITE INFORMATIONCANNEL
BY
Dl Lucie Count,,,,
APPLICANT'S NAME:
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LEGAL DESCRIPTION: / i Ga4S
PROPOSEI)SEPTICSI'STEMSIT'L INFORt1ATION
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, anti 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
Blocs.rornis. cptics.SepncApppPagc_Q7
CERTIFIED BY: ,
FLORIDA PROFES ION -AL NO.: -
DATE: /! - z �J�- ',JOB 110::' if?' 4iZ14e
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SCHEDULE A
LEGAL DESCRIPTION
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60D Packard Court ■ Safety Harbor, Florida 34695 s Telephone (727) 726-1138
www.jachomes.com/Floor—Plans
28" X 48'
1.280 SQUARE FEET
Model IMLT-44815B
(ALL SIZES ARE APPROJG) DESIGNED FOR ZONES U & fU Fgq.,1-Copy
Manufactured Home Installation Specifications
(Must be completed and submitted with your application)
Applicant
Address F(P
Manufacturers Name
Permit #
Roof Zone Wind. Zone_
No. of Sections Width 2f Length YK YearUll Serial #
Installation Standard Used (check) Manufacturers Manual 6 V1,11, 15C-1 66
Site Preparation
Debris and Organic Removal
Water Drainage: Natural Swale Pad Other
Foundation
Load bearing soil density Or assumed 1,000 psf
Footing type: Poured in place Portable
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Mainrail frame block: Sized')r?/ Placement o.c. ® r
Perimeter blocking: Size SIC rr)c If? Number W ^ .� Location V'&Wr- N e�1
Ridge beam support: Number Size Location
Center line blocking: Number Size Location
Special supports required (fireplace bay window) Yes No c
Mating of Units: Mating gasket /�U4%/" Type used ' ^AAV ALe,{-v i'4T
is
Fasteners: Roof Type • Spacing ` ..c.
Endwall Type t Spacing / r t o.c.
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Floors Type � _ Spacing ) ,g: c.
Anchors: Type 6,000 3,150
Height of Unit (top of foundation to frame):
Angle of straps !a
Number of frame ties Spacing O.C.
Number of over -roof ties (if required)
Number of sidewall anchors Zone II Z/ Zone III
Number of centerline anchors Number of stabilizers
Vents required for un inning (lsf/150 sf floor area): No.
Prepared by
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Date: — / 7 ` IO
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