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HomeMy WebLinkAboutOSTDS NEWI STATE OF FLORIDA AN DEPARTMENT OF HEALTH ifi�'� ONSITE SEWAGE TREATMENTI AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: PROPERTY ADDRESS: 4994 Deanna Fort Pierce. FL 34946 PERMIT #:56-SF-08767 APPLICATION #: AP1325999 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1094112 OSTDS #: 06-0109-R LOT: 4 BLOCK: 3 SUBDIVISION: Green Acres PROPERTY ID #: 1430-702-0020-000-5 I [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 [ 900 ] GALLONS / GPD Septic new CAPACITY A [ ] GALLONS / GPD i 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 [ 500 ] SQUARE FEET Dra R [ ' ] SQUARE FEET A TYPE SYSTEM: [ ] STANDARD I CONFIGURATION: [ ] TRENCH N F LOCATION OF BENCHMARK: Orange p, I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L iew SYSTEM SYSTEM ] FILLED [ ] MOUND [ ] BED [ ] X CL if rd center of property [ 9.00 ] [ INCHES FT ] [ ABOVE BELOW ] BENCHMARK/REFERENCE POINT [ 8.00 ][ INCHES FT ][ ABOVE BELOW] BENCHMARK/REFERENCE POINT D FILL REQUIRED: [ 17.00] INCHES I EXCAVATION REQUIRGU: I 1 i+w.nMQ The system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of O 300 gpd. T The licensed contractor installing the system is,, responsible for installing the minimum category of tank in accordance with H s. 64E-6.013(3)(9, FAC. E R SPECIFICATIONS BY: Brian J Ingr i TITLE: Environmental Specialist II APPROVED BY: T3�4;E: Environmental Specialist II St. Lucie CHD Brian J Ingran DATE ISSUED: 02/16/2018 EXPIRATION DATE: 08/16/2019 DR 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, PAC i Page 1 of 3 v 1.1.4 j AP1325999 SE1064906 r i NOTICE OF RIGHTS A party whose substantial interest is administrative hearing pursuant to sections 1 proceedings are governed by Rule 28-106, F administrative hearing must be In writing anc Department, within twenty-one (21) days fro Agency Clerk is 4052 Bald Cypress Way, BI Clerk's facsimile number Is 850-413-8743. Mediation Is not available as an alte Your failure to submit a petition for I constitute a waiver of your right to an admit order'. Should this order become a final or to judicial review pursuant to Section elate governed by the Florida Rules of Ap e by filing one copy of a Notice of Appeal wi second copy, accompanied by the filing fe; appropriate District Court. The notice mu' fected by this order may petition for an :0.569 and 120.57, Florida Statutes - Such h �rida Administrative Coe. Age petition Clerk for the must be received by i the receipt of this order. The address of the I A-02, Tallahassee, Florida 32399. The Agency native remedy. eating within 21 days receipt shall become a fiwill nal istrative hearing. and this order ter, a party who is adversely affected by it is entitled 8, Florida Statutes. Review proceedings are procedure. Such proceedings may be commenced h the Agency Clerk of the Department ofH I l h and a ;s required by law, with the Court of Appe t be filed within 30 days of rendition of the final order. i St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 HEATH PAYING ON: RECEIVED FROM: PAYMENT FORM: MAIL TO: Mary Bullington FACILITY NAME: _Ta yews I PROPERTY LOCATION: 4994 Deanna Fort Pierce, FL 34946 4 Lot: Property ID: 1430-702-0020-000-5 3 Block: CONSTRUCTION APPLICATION #: AP1325999 AMOUNT PAID: $ 515.00 PAYMENT DATE: 01/30/2018 or DESCRIPTION: QUANTI 1 Y r== EXPLANATION 128 - OSTDS Construction System Inspection Research Fee 1 $ 5.00 i 1 $ 15.00 -1 - Surcharge (All) 1 $ 100.00 -1 - OSTDS New Permit Surcharge -1 - OSTDS Construction Application and Plan Review,New 1 $ 100.00 1 $ 115.00 123 - OSTDS Construction Site Evaluation OSTDS Construction Permit (New orlMod, Amendment) 1 $ 55.00 126 - 1 1 $ 75.00 127 - OSTDS Construction System Inspection 1 $ 50.00 133 - OSTDS Construction Reinspect!on RECEIVED BY: WhighamJL AUDIT CONTROL NO. 56-PID-3473790 STATE OF MORIDA i DEPARTMENT OF HEALTH ONSITF. SEWAGE TREATb1E= AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PE =T I APPLICATION FOR: New System [ I ( I Repair ( I APPLICANT; I ► [=J L AGENT: RELIABLE TREASURE COAST System [ I Holding Tank nt ( I Temporary L I vLjQ -c INDIAN RIVER SEPTIC MAILING ADDRESS: PO Box 1116, Vero Beach, FL 32961 PERMIT DATE PAID: FEE PAID: RECBIPT #: ( I Innovative TELEPHONE: 772-562-4242 TO 8E COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MOST BE CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489.105(3)(m) OR 489.552, FLORID, 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: 1-4BLOCIf: SUBDIVISION: 6E=t�zel �S PLATTED: PROPERTY iD # : 11-2 't V �IrC [ � ZONING: ea 0-'Ix OR EQUIVALENT: [ Y f N) I i PROPERTY SIZE:(Je.ja ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC &`j<--2000GPD I I>2000GPD I IS SEWER AVAILABLE AS PER 381.0065, FS? ( Y © I DISTANCE ( TO SEWER: FT PROPERTY ADDRESS :. �G% f'� nq DIRECTIONS TO PROPERTY: X-Street: I Locate #: / Requested: I I BUILDING INFORMATION IV,3 RESIDENTIAL I I CM00RCIAI. I 'Unit Type of No: of Building Commercial/Institutional System Design No Establishment Bedr. ^om's Area Soft Table 1, Chapter 64E-6, FAC 1 t !/ 2 3 4 [ ] Floor/Equip" en Drains [i I 0 r (Specify) SIGNATURE: C' DATE: DH 4015, 08/09 (Obsolotes Previous editions which may not be used) Incorporated 64E-6.001, M Page I of 4 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: Mary Buif)ngton CONTRACTOR / AGENT: Reliable Treasure Coast LOT: 4 SUBDIVISION: Green Acres TO BE COMPLETED BY ENGINEER, HEALTH DEPAR' REGISTRATION NUMBER AND SIGN AND SEAL EACH PA( BLOCK: 3 APPLICATION # AP1325999 PERMIT # 56-SF-08767 DOCUMENT # SE1064906 :D# : 1430-702-0020-000-5 :NT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE of SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.17 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER -TABLE 2 ] GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] AUTHORIZED SEWAGE FLOW: 424.99 SQFT UNOBSTRUCTED AREA AVAILABLE: 750.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 I BENCHMARK/REFERENCE POINT LOCATION: Orange painted X CL if rd center of property ELEVATION OF PROPOSED SYSTEM SITE 9.00 [ INCHES / FT ] [ABOVE / BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING NORMALLY FEATURES THE [X]NO SURFACE WATER: FT DITCHES/SWALES: FT WELLS: PUBLIC: FT LIMITED USE: PRIVATE: FT NON -POTABLE: FT E: FT FT POTABLE WATER LINES: 35 FT BUILDING FOUNDATION 5 FT I PROPERTY LINES: 5 SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES LXJNvj 10 YEAR FLOOD ELEVATION FOR SITE: FT [MSL / NGVD l SITE ELEVATION: FT [ MSL / NGVD FORMATION SITE 1 I SOIL PROFILE INFORMATION SITE 2 SOIL PROFILE INF USDA SOIL SERIES:Nettles sand Munsell #/Color Texture Depth 10YR 3/1 Sand 0 To.4 10YR 4/1 Sand 41 To 21 10YR 5/1 Sand 21 To 29 10YR 6/1 Sand 24 To 34 10YR 2/2 Sand 34 To 39 7.5YR 314 Sand 39 To 44 10YR 514 Sand 44 To 51 10YR 6/4 Sand 51 To 72 USDA SOIL SERIES:Nettles sand Munsell #/Color Texture Depth 10YR 311 Sand 0 To 5 10YR 4/1 Sand 5 To 25 10YR 5/1 Sand 25 To 31 10YR 611 Sand 26 To 35 10YR 3/2 Sand 35 To 41 7.5YR 314 Sand 41 To 46 10YR 5/3 Sand 46 To 55 10YR 6/4 Sand 55 To 72 OBSERVED WATER TABLE: 57.00 INCHES [ ABOVE / SELOW j EXISTING GRADE TYPE: ESTIMATED WET SEASON WATER TABLE ELEVATION j: 25 INCHES [ ABOVE / BELOW ] HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO [ PERCHED / APPARENT ] EXISTING GRADE DEPTH: 25.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.60 DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [X] BED [ ] OTHER (SPECIFY) r REMARKS/ADDITIONAL CRITERIA UT determined using USDA WSS and soil borings. t6/1 stripping in 10YR5/1 matrix >10% with diffuse boundaries starting @ 25" in S61. 9" above BM. SB211" above BM �4::�2 SITE EVALUATED BY: - Ingram, Brian (Title: Envir ental Specialist II) (ENVIRONMENTAL HEALTH) DH 4015, 08/09 (obsoletes previous editions whI ich may not be used) Incorporated: 64E-6.001, FAC AP1326999 EID350714 DATE: 02/08/2018 Page 3 of 4• v 1.0.2 ER AUTHORIZATION I M A--� PRINT Name Authorize Reliable Treasure Coast Services Indian River Septic PRINT Name of Agent(s) To apply for an Onsite Sewage Treatment and Disposal System Permit from the Florida Department of Health — St Lucie (County on my behalf for the property with the address of: If not utilized within six months from the date of my signature, this authorization will become void. No changes to this authorization are valid without my signature. PRINT Nae of Signatory I Tax Deed File No. Property Identification No. Original Owners of Record: ST. LUCIE COUNTY 15-721 h 1430-702-0020-000/5 TAMERA ZINKER TAX D E!ED I State of Florida JOSEPH E SWATH, CLERK OF THE CIRCUIT COURT SAINT LUCIE COUNTY FILE # 437034211/1412017-04:44:47 PM rxDEED OR BOOK 4064 PAGE 1069 -1069 Doc Type: RECORDING: $10.00 Doc StarnP: $74.90 FOR OFFICIAL USE ONLY The following Tax Sale Certificate Numbered issued on 6/1113, was filed in the office of the tax collector of this . County and application made for the issuance of a tax deed, the applicant having paid or redeemed all other taxes or tax sale certificates on the land described as required by law to be paid or redeemed, and the costs and expenses of this sale, gand due notice of sale having been published as requiredlby law, and no person entitled to do so having appeared to redeem said land; such land was sold on the 19T" day of December, 2016, offered for sale as required bylaw for cash to the highest bidder and no bids were received. Such land was on the 14th day of November, 2017 was sold from the List of Lands Available for Taxes and was sold to MARY and WILLIAM BULLINGITON, whose address is 7402 CABANA LANE, FORT PIERCE, FL 34951. Now, on this 14th day of NOVEMBER, 2017, in the County of St. Lucie, State of Florida, in consideration of the sum of ($10,686.38) TEN THOUSAND SIX HUNDRED 6GHTY-SIX DOLLARS AND THIRTY-EIGHT Cents only, being the amount paid pursuant to the Laws of Florida does hereby sell the following lands, including any hereditaments, buildings, fixtures and improvements of any kind and description, situated in the County and State aforesaid and described as follows: i GREEN ACRES -UNIT 3- BLK 3 LOT 4 (OR 833-2842: 1354-738) Witness: i MARGARET HAL SANDRA COLEMAN State of Florida i JOSEPH E SMITH, Clerk of the t;irculi noun ST. LUCIE COUNTY, Florida ST. LUCIE COUNTY On the 14th day of NOVEMBER, 2017, before ANGELA RIGGINS personally appeared ALICE SENNOTT known to"me to be the person described in, and who executed the foregoing instrument, and acknowledged the execution of this instrument to be his own free act'and deed fo,r the use and purposes the in-mentioned.X"r .> Witness my hand and office seal date aforesaid. AN G ELA RI G S, Notary Public �•Yn. ANGEIh RIGGI S MY COMMISSION t FF 926553 EXPIRES: October 12, 0019 a' Bonded Tbru Notary Pubk Undermitem S(_ Sr, 0'670 1/30/201812:07 PM Sales Receipt #17521 Store: 1 St Lucie County Health Department 5150 NW Milner Drive Port St Lucie, FL 34983 Environmental Health Division 772••873-4931 Item # Qty Price Ext Price g 1 $75.00 $75.00 T *Initial Inspection 3 1 $100.00 $'100.00 T "New Application 30 1 $50.00 $50.00 T *New Other Inspectic 5 1 1 $55 00 $55.00 T *New Permit 7 1 1 $5.00 $5.00 T "New Research Sure 4 1 $115.00 $115.00 T *New Site Evaluation 2 1 $100.00 $100.00 T *New System Count 1 1 $15 00 $15.00 T *OSTDS County_ Sur Subtotal: $515 00 Local Sale-. Tax 0 % Tax + $0.00 RECEIPT TOTAL: $515.00 Check: $515.00 5095 4994 Deanna Lane Thank You & Have a Good Day! I��I�I ,��II I���I ill,i iI�01 IIII I�� 'roperty Card Page 1 of 1 ° Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved. Property Identification Site Address: 4994 Parcel ID: 1430-702-0020- Account #: 10293 Sec/Town/Range: DEANNA LN 000-5 1 30/34S/40E Map ID: 14/30S Zoning: RMH-5 Use Type: 0000 Jurisdiction: Saint Lucie County Ownership William Bullington Mary Bullington 7402 Cabana LN Fort Pierce, FL 34951-2705 Current Values Just/Market: $8,400 Assessed: Exemptions: $0 Taxable: Date 11-14-2017 01-05-2001 03-26-1993 View: Year Built: N/A Primary Wall: Bedrooms: 0 Full Baths: 0 Half Baths: 0 Legal Description GREEN ACRES -UNIT 3- BLK 3 LOT 4 (OR 4064-1069) $7,040 Year Just/Market $7,040 2017 $8,400 2016 $6,400 2015 $6,400 Historical Values 3-year Assessed Exemptions Taxable $7,040 $0 $7,040 $6,400 $0 $6,400 $6,400 $0 $6,400 Sale History Book/Page Sale' Code Deed Grantor 4064 / 1069 0111 TD Zinker Tamera 1354 / 0738 XX01 QC Zinker,Leola 0833 / 2842 XX01 QC Danion Merritt Primary Building Information Finished Area of this building: 0 SF Gross Area of this building: 0 SF Exterior Data Roof Cover: Roof Structure: Frame: Grade: Story Height: No. Units: 0 Interior Data A/C %: 0% Electric: Heated %: N/A% Heat Type: Sprinkled %: 0% Heat Fuel: Price $10,700 $100 $100 Building Type: Effective Year: 2014 Secondary Wall: Primary Int Wall: Avg Hgt/Floor: 0 Primary Floors: Total Areas Finished/Under Air 0 (SF): i r Gross Area (SF): 0 Land Size (acres): 0.17 r f I Land Size (SF): 7,500 Total Building Count: 1 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 2018 Saint Lucie County Property Appraiser. All rights reserved. ittp://www.paslc.org/RECard/ 1/30/201 f