HomeMy WebLinkAboutSEWAGEAPPLICATION #:AP1406060
STATE OF FLORIDA PERMIT #:56-SF-1767495
DEPARTMENT OF HEALTH DOCUMENT # : F11282665
' ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM 03/2P/2019
�t CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:
SCANNED
FEE PAID:95.00
RECEIPT #:56-PID-3892503
n
APPLICANT: Anne lanniccheri
AGENT: Dave Golden Dave Golden Homes FINED
PROPERTY ADDRESS: 12739 Refuge Ln Fort Pierce, FL 34982 n`
11
LOT: 2
BLOCK: MAC .Q 1O19
Pe
SUBDIVISION: Edens Refuge ID#: 4604-702-0003-000-5 St.thng Depart
rin
CHECKED [XI ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
SETBACKS
[ ]
[01]
TANK SIZE [1] 1090.00 [21 483.00
[
]
[271
SURFACE WATER
FT
[ ]
[021
TANK MATERIAL Polypropylene
[
]
[281
DITCHES
FT
[ ]
[03]
OUTLET DEVICE
[
]
[291
PRIVATE WELLS
100
FT
Y N ]
[
]
[30]
PUBLIC WELLS
FT
[ ]
[041
MULTI -CHAMBERED [
[ ]
[051
OUTLET FILTER Polylok PL-68
[
]
[31]
IRRIGATION WELLS
FT
[ ]
[061
LEGEND 1. 70-143-11DC4 2. 70-143-54SC4
[
]
[321
POTABLE WATER
75
FT
[ ]
[071
WATERTIGHT
[
]
[331
BUILDING FOUNDATIONS
6
FT
[ ]
[OS]
LEVEL
[
]
[341
PROPERTY LINES
5
FT
[ ]
[091
DEPTH TO LID
[
]
[351
OTHER
FT
DRAINFIELD INSTALLATION
FILLED / MOUND SYSTEM
[ ]
[10]
AREA [1] 585 [21 SQFT
[
]
[361
DRAINFIELD .COVER
[ ]
[11]
DISTRIBUTION BOX HEADER X
[
]
[371
SHOULDERS
[ ]
[121
NUMBER OF DRAINLINES 1. 6.00 2.
[
]
[381
SLOPES
[ ]
1131
DRAINLINE SEPARATION
[
]
[391
STABILIZATION
[ ]
[141
DRAINLINE SLOPE
ADDITIONAL INFORMATION
[ ]
(151
DEPTH OF COVER !
[ ]
[161
ELEVATION [ ABOVE / BELOW IBM 25.00
[
]
[401
UNOBSTRUCTED AREA
[ ]
[17]
SYSTEM LOCATION
[
]
[41]
STORMWATER RUNOFF
I I
[181
DOSING PUMPS '
I
I
[421
ALARMS
[ ]
[191
AGGREGATE SIZE
[
]
[431
MAINTENANCE AGREEMENT
[ I
[201
AGGREGATE EXCESSIVE FINES
[
]
[44]
BUILDING AREA
[ ]
[211
AGGREGATE DEPTH
[
]
[45J
LOCATION CONFORMS WITH
SITE PLAN
SITE GRADING
FILL / EXCAVATION MATERIAL
[ ] [46] FINAL
[ I
[221 FILL AMOUNT
[ I t471 CONTRACTOR
Brian Davis (Brian Davis Sept
[ ] [48] ° R
INFIL 0R ARC z=
[ ]
[23] FILL TEXTURE
[ ]
(24] EXCAVATION DEPTH
ABANDONMENT
[ ]
[251 AREA REPLACED
[ ] [491 TANK PUMPED
[ ]
[261 REPLACEMENT MATERIAL
[ ] [501 TANK CRUSHED
& FILLED
Comments: Comments are on page 2.
CONSTRUCTION I 'APPROVED / St. Lucie v4m DATE: 04/26/2019
DISAPPROVED ° Env ron ntal Specialist II Sri ram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM [ APPROVED / DISAPPROVED ] : Lucie CHD DATE: O4/2�t��,�
Environmental Specialist II B a J Ingram (ENVIRONMENTAL HEALTH)
(Explanation of Violations on following page)
DH 4016, 08109 (Obsoletes all previous editions which may not be used)
Incorporated:. 64E-6.003, FAC Page 2 of 3
EH Database v 1.0.1 AP1406060 EID1767495
I
rlk
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
Comments
APPLICATION #:AP1406060
PERMIT #:56-SF-1767495
DOCUMENT #:F11282665
DATE PAID:03/29/2019
FEE PAID:95•00
RECEIPT #:56-PID-3892503
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 460
gpd. New ST, filter, DT, and 3x6+3x7 long DF installed. No violations, system ok to cover. Contractor notified onsite. No final
inspection required. Final system approved. Contractor and building department emailed final approval.
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
EH Database v 1.0.1 AP1406060 EI01767496
Page 2 of 3