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HomeMy WebLinkAboutOSTDS NEWSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT SYSTEM CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Larry Prevo PROPERTY ADDRESS: 210 N Brocksmith Rd Fort Pierce, FL 34945 LOT: BLOCK: SUBDIVISION: i PERMIT 4: 56-SF-1 824402 APPLICATION # : AP 1329630 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1095634 PROPERTY ID #: 2308-132-0009-000-0 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] i [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 Sebtic new CAPACITY A [ ] GALLONS / GPD IN/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 [ 334 ] SQUARE FEET Drainfield new SYSTEM R [ ] SQUARE FEET N/A 1 SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ],FILLED [X] MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: Yellow capped IR SE property corner I ELEVATION OF PROPOSED SYSTEM SITE [ 3.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 4.00 ][FINCHES FT ][ ABOVE BELOW] BENCHMARK/REFERENCE POINT M rr D E 0 T H E R ILL REQUIRED: ["1b.UU] INCHES EXCAVATION REQUIRED: t J 1NUUN5 The system is sized for 1 bedrooms with a maximum occupancy of 2 persons (2 per bedroom), for a total estimated flow of 200 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. SPECIFICATIONS BY: Brian J Ingr, m TITLE: Environmental Specialist II APPROVED BY: DATE ISSUED: DH 4016, 08/09 Incorporated: j, TITLE: Environmental Specialist II Brian J Ingram ff 02/27/2018 EXPIRATION DATE: (Obsoletes all previous editions which may not be used) 64E-6.003, FAC St. Lucie CHD 08/27/2019 Page 1 of 3 v 1.1.4 AP1329630 SE1066346 NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an. administrative hearing pursuant to sections 120569 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 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 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. V" ®GJ\A HEALTH PAYING ON: RECEIVED FROM: PAYMENT FORM: MAIL TO: Larry Prevo FACILITY NAME: PROPERTY LOCATION: St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 PERMIT M 56-SF-1824402 BILL DOC #:56-BID-3674205 CONSTRUCTION APPLICATION M AP1329630 Larry Prevo AMOUNT PAID: $ 515.00 CREDIT CARD PAYMENT DATE: 02/20/2018 210 N Brocksmith Rd Fort Pierce, FL 34945 Lot: Block: Property ID: 2308-132-0009-000-0 EXPLANATION or DESCRIPTION: QUANTITY FEE 128 - OSTDS Construction System Inspection Research Fee 1 $ 5.00 -1 - Surcharge (All) 1 $ 15.00 -1 - OSTDS New Permit Surcharge 1 $ 100.00 -1 - OSTDS Construction Application and Plan- Review,New 1 $ 100.00 123 - OSTDS Construction Site Evaluation 1 $ 115.00 126 - OSTDS Construction Permit (New or Mod, Amendment) 1 $ 55.00 127 - OSTDS Construction System Inspection 1 $ 75.00 133 - OSTDS Construction Reinspection 1 $ 50.00 RECEIVED BY: WhighamJL AUDIT CONTROL NO. 56-PID-3484832 j}SE STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM •�`0p°e'` APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [v/] New System [ ] Existing System [ ) Holding Tank [ ] Repair [ ] Abandonment [ ) Temporary PERMIT NO. DATE PAID. FEE PAID: RECEIPT #: [ ] Innovative [ ] APPLICANT: L eL( ( C' —tL IL I y L) AGENT: TELEPHOXJ'1 I t ,) 5 a `T MAILING ADDRESS: 6 , V h_ f-CL Q a rcp-- L J TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489. 10,'5 (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. ===cocccoccoac0000cDeco===cc=ccccoo=occ=c�=vc=c=ccca=Co==v=ccc=========c:=ee=cc=acccv=ec== PROPERTY INFORMATION LOT: BLOCK: SUBDIVISION: PLATTED: PROPERTY ID #:)��-I3'-C))q'°-(1ZONING: I/M OR EQUIVALENT: [ Y/(I�] PROPERTY SIZE: v ACRES WATER SUPPLY: [V'* PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y 10 DISTANCE TO SEWER: FT PROPERTY ADDRESS: 7- 1 <-,- A (-,>ro . )z� S1v% •4 [^ Peel Fc, +' i , Ce e_r � P- SIf 1 I/ S- DIRECTIONS TO PROPERTY: BUILDING INFORMATION [�� RESIDENTIAL [ ] COMMERCIAL Unit Type of No. of Building Commercial/Institutional System Design No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, PAC 1 � 5.� �� Lr C,PD 2 q 0.15 k = Q(;?- �w 3 4 I ] Floor/Equipment Drains [ ] Other (Specify) DR 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC Page 1 of 4 STATE OF FLORIDA APPLICATION # AP1329630 DEPARTMENT OF HEALTH PERMIT # 56-SF-1824402 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE1066346 SITE EVALUATION AND SYSTEM I SPECIFICATION APPLICANT: Larry Prevo CONTRACTOR / AGENT: LOT: BLOCK: SUBDIVISION: ID# :j 2308- 1 32-0009-000-0 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]YES [ ]NO NET USABLE AREA AVAILABLE: 0.81 ACRES TOTAL ESTIMATED SEWAGE FLOW: 200 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 1215.01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 500.00 SQFT UNOBSTRUCTED AREA REQUIRED: 500.00 SQFT I BENCHMARK/REFERENCE POINT LOCATION: YellOw,'CappedlR SE ELEVATION OF PROPOSED SYSTEM SITE 3.00 [ INCHES / FT ] [ ABOVE / BELOW ] 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 [X]NO WELLS: PUBLIC: FT LIMITED USE:I FT PRIVATE: 100 FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 10 FT SITE SUBJECT TO FREQUENT FLOODING? [ ;]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]Ng 10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD enrT. DDnWTT.r TwrnDMLTTAN ATTF. 1 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES:Nettles sand Munsell #/Color Texture Depth 10YR 5/1 Fine Sand 0 To 13 10YR 6/2 Fine Sand 13 To 25 10YR 6/1 Fine Sand 17 To 25 1 OYR 7/2 Fine Sand 17 To 31 10YR 4/3 Sand 31 To 38 10YR 5/2 Sandy Clay Loam 38 To;59 10GY 6/1 Loamy Sand 59 To;72 I I USDA SOIL SERIES:Nettles sand Munsell #/Color Texture Depth 10YR 5/1 Fine Sand 0 TO 13 1 OYR 6/2 Fine Sand 13 To 25 10YR 7/2 Fine Sand 17 To 33 10YR 6/1 Fine Sand 18 To 25 1 OYR 3/4 Sand 33 To 41 10YR 5/2 Sandy Clay Loam 41 To 55 10GY 6/1 Loamy Sand 55 To 72 OBSERVED WATER TABLE: 60.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 17 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 17.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Fine Sand/0.60 DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [X ] BED [ } OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA WSWT determined using USDA WSS and soil borings. 10YR6/1 and 10YR7/2 stripping in 10YR6/2 matrix >10% with diffuse boundaries starting at 17" In SB1. SB1 3" below BM. SB2 2" below BM. �) SITE EVALUATED BY: Ingram, Brian (Title: E livironmental Specialist II) (ENVIRONMENTAL HEALTH) DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC AP1329630 EID1824402 DATE: 02/26/2018 Page 3 of 4 v 1.0.2 .Jroperty Gard Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved. Property Identification Site Address: 210 N Parcel ID: 2308-132-0009- Account 4: 13045 Sec/Town/Range: BROCKSMITH RD 000-0 08/35S/39E Map ID: 23/08N Zoning: AG-2.5 Use Type: 0100 Jurisdiction: Saint Lucie County Ownership Legal Description Kim R Prevo 8 35 39 FROM SW COR OF SW 1/4 OFNE 1/4 RUN E 42.5 Larry Prevo FT, TH N 626.4 FT TO POB, TH N 196.5 FT, TH E 132.25 FT, 210 N Brocksmith Rd TH S 126.5 FT, TH E 132.25 FT, TH S 70 FT, TH W 264.5 FT Fort Pierce. FL 34945 TO POB (0.81 AC) (OR 737-932: 1018-874: 2728-403) Current Values Historical Values 3-year Just/Market: $93,000 Assessed: $74,100 Year Just/Market Assessed Exemptions Taxable Exemptions: $49,100 Taxable: $25,000 2017 $93,000 $74,100 $49,100 $25,000 2016 $84,400 $72,576 $47,576 $25,000 2015 $77,100 $72,072 $47,072 $25,000 Sale History Date Book/Page Sale Code Deed Grantor Price 12-08-2006 2728 / 0403 XX01 ; DE Smith,Kim R $100 04-12-1996 1018 / 0874 XX04 WD John N Smith $5,000 04-29-1991 0737 / 0932 XX00, WD $15,000 Primary Building Information Finished Area of this building: 1,410 SF Gross Area of this building: 2,239 SF View: Year Built: 1998 Primary Wall: Wood/Sheath Bedrooms: 3 Full Baths: 2 Half Baths: 0 Roof Cover: Fibrglss Shg Frame: Story Height: 2 Story A/C %: 100% Heated %: 100% Sprinkled %: N/A% Exterior Data Roof Structure: Gable Grade: C- No. Units: I Interior Data Electric: MAXIMUM Heat Type: FrcdHotAir Heat Fuel: ELEC Total Areas Building Type: HC- Effective Year: 1998 Secondary Wall: Primary Int Wall: Avg Hgt/Floor: 0 Primary Floors: Carpet Finished/Under Air 1,410 (SF): Gross Area (SF): 2,239 Land Size (acres): 0.81 Land Size (SF): 35,283.6 Total Building Count: 1 Special Features and Yard Items Type Qty Units Year Bit CHAINLINK 4' 1 120 1998 UTILITY GOOD 1 144 1999 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. Page 1 of :tp://www.paslc.org/RECard/ 2/15/2018 56- SF- ! $2. N goZ, APPLICANT'S NAME:- 4�alyr5z � �`i%Bt ���1✓0 LEGAL DESCRIPTION: Rwce✓ �w y ,,r �; PROPOSEi3 SEW 'EI1iFOR1�fAT7Q1Y 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 �yater 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, tilled 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 rorms:sepua.Sept CApppRAIV207 CERTIFIED BY: FLORIDA PROFESSIO'SAL NO.:... DATE:-"/G>'�' APPLICANT'S NAME: `gr� LEGAL DESCRIPTION: /�eg �,D.2132-aZ299 Gk-AO-O .erg+;'7.T"y'w.vY 'a^vca�s•r +vM Pa.+++ � ,�'r4a 7'!^' +, 1�'�Krr" .,,n' aa•*a-w!^'ti-•n a Kos t^v+..�"Nn-i'�S'E;.. ��i 1 �� F ,, r U k � �U��PRO,DOSED'SEPTI��YSTEISIZ'.�yINFO.RII�A:TIUN�.��;� _ ��;,�:� 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. diicv riimis;septics,.SepticApppPagc'-07 CERTIFIED BY: /'/G-S i%70/dlo FLORIDA PROFESSION DATE: JOi7 NO: j� 'r, APPLICANT'S NAME: Ao�; LEGAL DESCRIPTION: prcc/ro t d,F.;j"�'T� r-�.nesr,.: c� wv, r r> Cr!rt- r^ rc c^ rra�x• r rs �' -+ct �s-r,.-w, a�'a.T^r ^7 �t 6�--r F ���ar ,ti :PROOSEi1 SEPTIG'SPST'EMSl'E INFORMAT'ION�,�:}nga� G� ;�F' _.� _ _ , 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 orwell 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 surTface 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. i The natural grade elevation in the area of the proposed septic system and the benchmark must be shown on the site plan. Please lopate the benchmark within 200 feet of the proposed septic system. NOTE: MUST BE CERTIFIED BY A FLORIDA REGISTERED SURVEYOR OR ENGINEER. does, fonns,scpties;SepticApppPagc207 M CERTIFIED BY: FLORIDA PROFESSIONAL NO.: DATE: 2 /G�= /$ JOB O.:/7-•