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Home My WebLink AboutOSTDS NEWN,,,r -#- *03 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT SYSTEM CONSTRUCTION PERMIT FOR APPLICANT: Brion Paulev PROPERTY ADDRESS: LOT OSTDS New 750 DISPOSAL SCANNED BY St Lucie C®untV 5333 Emerson Ave Fort Pierce FL 34951 BLOCK: PROPERTY ID #: 1310-441-0021-000-3 SION: PERMIT #:56-SF-1829231 APPLICATION #: AP1332755 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1098477 [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 I 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 Seotic new, CAPACITY A -[ ] GALLONS / GPD N/A I 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 Drainfield new sY R [ ] SQUARE FEET N/A SY A TYPE SYSTEM: [ ] STANDARD [X] FILLED • I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: orange painted nail in cabbage I ELEVATION OF PROPOSED SYSTEM SITE [ 10.00][� E BOTTOM OF DRAINFIELD TO BE [ 12.00 ] [� L D E O T H E R [ ] MOUND [ ] alm SE of system dCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT 1CHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT 'ILL REQUIRED: t-10.UU] INCHES EXCAVATION HEQUIX6U : i i The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300 gpd. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E-6.013(3)(f), FAC. Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsdd so as to prevent the tank from retaining water, and(c) The tank shall be filled with clean sand or other suitable material, and completely covered with soil.H (Comments Continued on Page 2.) SPECIFICATIONS BY: Brian J I ram TITLE: Environmental Specialist II APPROVED BY: TITLE: Environmental Specialist II Brian J I ram DATE ISSUED: 03/19/2018 EXPIRATION DATE: - DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC v 1.1.4 AP1332755 File ®� St. Lucie CHD 09/19/2019 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 miust be received by the Agency Clerk for the Department, within twenty-one (21) days from te 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 1 gency 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 fi�ed within 30 days of rendition of the final order. l J FC6-ft"R HE WH PAYING ON: PERMIT RECEIVED FROM: Cal B PAYMENT FORM: CHEC MAIL TO: Brion Pauley FACILITY NAME: PROPERTY LOCATION: 5333 Emerson Ave Fort Pierce, FL 34951 Lot: St. Lucie County Health Department 5150,NW Milner Dr Port Saint Lucie, FL 34983 -1829231 BILJ Doc #:56-BID-3683446 CONSTRUCTION APPLICATION #: AP1332755 Block: Property ID: 1310-441-0021-000-3 I EXPLANATION or DESCRIPTION: `428 - OSTDS Construction System Inspection Research Fee -1 - Surcharge (All) -1 - OSTDS New Permit Surcharge -1 - OSTDS Construction Application and Plan Revie ,New 123 - OSTDS Construction Site Evaluation 126 - OSTDS Construction Permit (New or Mod, Amendment) 127 - OSTDS Construction System Inspection I 133 - OSTDS Construction Reinspection RECEIVED BY: WhighamJL AMOUNT PAID: $ 515.00 PAYMENT DATE: 03/08/2018 QUANTITY FEE 1 $ 5.00 1 $ 15.00 1 $ 100.00 1 $ 100.00 1 $ 115.00 1 $ 55.00 1 $ 75.00 1 $ 50.00 AUDIT CONTROL NO. 56-PID-3494374 i STATE OF FLORIDA PERMIT NO. )Q,, Q 1 DEPARTMENT OF HEALTH DATE PAID ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: 1 , SYSTEM RECEIPT # : APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [✓] New System [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT: Brion Pauley AGENT: Cal Builders Inc I TELEPHONE: 772-562-3715 MAILING ADDRESS: 2020 Old Hwy Dixie HSE Ste 6I, Vero Beach, FI. 32962 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 DQCUMENTATION OF THE DATE THE LOT WAS CREATED OR PLATTED (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. PROPERTY INFORMATION ' LOT: BLOCK: SUBDIVISION: See Attached PLATTED: PROPERTY ID # : 1310-441-0021-000-3 ZONING: I/M OR EQUIVALENT: [ Y / N ] PROPERTY SIZE: 4.34 ACRES WATER SUPPT,Y: [ ✓] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: 5333 Emerson Ave DIRECTIONS TO PROPERTY: North on Emerson From Indrio Rd Property on west side of Emerson Rd 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 Single Familly 3 �I 1792 125q ma) 2 3 4 I [ ] Floor/Equipment Drains [ ] Other (Specify) I SIGNATURE, : DATE: DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC Page A of 4 I ' STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION i I APPLICANT: Brion Pt CONTRACTOR / AGENT: • LOT: SUBDIVISION: Cal Builders Inc. ' ID#: APPLICATION # AP1332755 PERMIT # 56-SF-1829231 DOCUMENT # SE1069067 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: [X]YE TOTAL ESTIMATED SEWAGE FLOW: 300 GALL( AUTHORIZED SEWAGE FLOW: 6509.99 GALL( UNOBSTRUCTED AREA AVAILABLE: 1500.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: orange ELEVATION OF PROPOSED SYSTEM SITE 10.00 [ ]NO NET USABLE AREA AVAILABLE: 4.34 ACRES PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ] PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT :d nail in cabbage palm SE of system INCHES / FT ] [ ABOVE / BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: 75 FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT'' LIMITED USE: I FT PRIVATE: 75 FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 20 FT POTABLE WATER LINES: 10 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES 10 YEAR FLOOD ELEVATION FOR SITE: FT SOIL PROFILE INFORMATION SITE 1 USDA SOIL SERIES:Pineda sand Munsell #/Color Texture Depth 10YR 4/2 Sand 0 To 7 1 OYR 4/3 Sand 7 To 19 10YR 7/2 Sand 19 To 37 10YR 5/8 CMN/PRM RF 26 To 37 10YR 6/3 Sand 37 To 47 10YR 711 Sand 47 To 72 [ X 4 NO 10 YEAR FLOODING? [ ] YES [ X ] NO] MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD QATT. DRAT. TT.F TNFADMnTTAN ATTF. 9 USDA SOIL SERIES:Pineda sand Munsell #/Color Texture Depth 10YR 4/2 Sand 0 To 7 10YR 4/3 Sand 7 To 19 10YR 7/2 Sand 19 To 37 10YR 5/8 CMN/PRM RF 27 To 37 10YR 6/3 Sand 37 To 48 1OYR 7/1 Sand 48 To 72 OBSERVED WATER TABLE: 49.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 26 I INCHES [ ABOVE / BELOW ] EXISTING GRADE XIGH WATER TABLE VEGETATION: [X]YES [ ]NO I MOTTLING: [X]YES [ ]NO DEPTH: 26.00 INCHES SOIL'TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.60 DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [X ] BED [ ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA r �I WSWT determined using USDA WSS and soil borings. r 10YR5/8 CMN PROM RFs mottling In `10YR7/2 matrix >2% starting at 26" in S131. S131 and SB2 10" below BM. SITE EVALUATED BY: V Ingram, Brian (Title: En onmental Speclalist 11) (ENVIRONMENTAL HEALTH) DH,4015, 08/09 (Obsoletes previous editions which not be used)' Incorporated: •64E-6.001, FAC AP133�I2755 EID1829231 DATE: 03/14/2018 Page 3 of"A V 1.0.2 K, Rick Scott Mission: Governor To protect, promote & improve the health of all people in Florida through integrated t All John H. Armstrong, MD, FAGS state, county& community efforts. Qa }, l !� ( I I State Surgeon General & Secretary Vision: To be the Healthiest State in the Nation i AUTHORIZATION PRINT Name of Owner autt orize ��a_.._# �y.9��. _� ........... .... PRINT Name of Agent(s) to apply for an Onsite Sewage Treatment and Disposal System Permit from the Florida Department of Health in Indian River County on my behalf for the 'property with the address of: If not utilized within six months from the Changes to this authorization are valid N of owner PRINT Name of Signatory Florida Department of Health of my signature, this authorization will become void. No it my,signature. Date I y. w�.FloridasHeaith.com TWITTERHeallhyFLA FACEBOOK:FLDepartmentofHealth , YOUTUBE: fldoh