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SCANNED
BY
St Luc COunty
APPLICATION tj:AP 9334 iO9
STATE OF FLORIDA
PERMIT #:56';.SF 1831275.
$
DEPARTMENT OF HEALTH
'DOCUMENT #:FI12591,82
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
DATE PAID 04/.25/2:01.8
CONSTRUCTION INSPECTION AND FINAL APPROVAL
FEE PAID.25v00.
I
RECEIPT #:5:6'-PID=3523531
APPLICANT: Milissa �DUfnet (A35oci8ted Homes InG) I
AGENT: Dave Golden (Dave Golden Homes) I
PROPERTY ADDRESS: 5105 Palmetto Dr Fort Pierce, FL 34982
LOT: 32-33 BLOICK : 5
SUBDIVISION: Indian River.Estates ID#': 3402-606.0029-000-2
CHECKED [X] ITEMS ARE NOT IN COMPhIANCE WITH STATUTE OR RULE'AND MUST BE CORRECTED,
TANK INSTALLATION
SETBACKS
[ ] [01] TANK SIZE [1] 1050.00 [2'1 [ ]
[271
SURFACE WATER
FT
[ ] [021 TANK MATERIAL Concrete',I [ 3
[28,],
DITCHES 21
FT
[ ] [031 OUTLET DEVICE I [ ]
[291
PRIVATE'. WELLS
FT
[ ] [04'] MULTI -CHAMBERED [ Y N ] [ ]
I
[30`]
PUBLIC WELLS
FT
[ ] [05] OUTLET 'FILTER Polylok PL-122 [ ]
[31]
IRRIGATION WELLS
FT
[ ] [0-6,] LEGEND' 1, 01-011-09DC3 2. I [ ]
[32.],
POTABLE WATER 40
FT
[ ] [07] WATERTIGHT I [ ]
[331.
BUILDING FOUNDATIONS 7:
FT
] [08] LEVEL I [ ]
1341
PROPERTY LINES 5
FT
[ ] 1091. DEPTH TO 'LID [ ]
I
[35]
OTHER
FT
DRAINFZELD INSTALLATION
FILLED / MOUND SYSTEM
[ ] [lA]. AREA [1] 672 [21 I SQFT [ ]
[361
DRAINFIELD COVER
[ ] [11] DISTRIBUTION BOX HEADER X' [ ]
[371
SHOULDERS
[ ] [121 NUMBER OF DRA=NLI14ES 1..7.00I 2, [ ]
[381
SLOPES
[ ] [131 DRAINLINE ,SEPARATION I [ ]
[.39]
STABILIZATION
[ ] 1141 DRAINLINE SLOPE l
I
[ ] 1151 DEPTH OF'COVER i
ADDITIONAL
INFORMATION
[ ] [161 -ELEVATION [, ABOVE, / BELOW ] BM. S;OQ ( ]
['40:]
'UNOBSTRUCTED 'AREA
[ ] [17] :SYSTEM LOCATION
[411
STORMWATER RUNOFF
[ ] [18] DOSING PUMPS I ]
[42]
ALARMS'
[ ] [191 AGGREGATE SIZE I [, ]
[43.1
MAINTENANCR AGREEMENT
[ ] [20] AGGREGATE EXCESSIVE FINES [ ],
[441
BUILDING AREA
[ ] [21] AGGREGATE DEPTH [ ]
1[4'5]
LOCATION CONFORMS WITH SITE PLAN
46
FINAL SITE GRADING
FILL / EXCAVATION MATERIAL
L
]
L ].
L
]
[47]
CONTRACTOR David. -Whiteside (Accurate.Se
[ ]
[22] FILL AMOUNT
L
]
[48]
OTHER INFILTRATOR.Quick4 EQ36 (single c
[ ]
[23] FILL TEXTURE
[ ]
[241 EXCAVATION DEPTH
ABANDONMENT
[ ]
[25.] AREA REPLACED
L
]
[49]
TANK PUMPED
[ ]
[261 REPLACEMENT MATERIAL
[
]
[501
TANK CRUSHED & FILLED
Comments: Comments are on page 2.
CONSTRUCTION [ APPROVED. / St., Lucie CHD DATE; 10/15/2018
DISAPPROVED ]'0 Envi[ enfal Specialtst'il'Bria J,Ingram'(ENVIRONMENTAL HEALTH)
FINAL SYSTEM [ APPROVED / St. Lucie CHD DATE: 01111/2019
DISAPPROVED ]:
'Environmental Spe t 1I an J Ingram (ENVIRONMENTAL HEALTH)
(Explanation of,Violations on following page) _ s
DH 4016, 08/09 (Obsoletes, all previous editions which may not be Vsed)
Incorporated: 64E-6,003, FAC Page 2 of 3'
EH Database v 1.0.1 AP1334109 CID1831275
STATE. OF. FLORIDA
DEPARTMENT' OF HEALTH
ONSIT9.SEWAGE. TREATMENT ANDDISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
APPLICATION P 1-334109.
PERMIT fvffi=SF-1 83-127-5
b0cbWOT: wz..9125.9182
DATE PAIMZ04=016
FEE PAID.125-001
:"cE:rPT #.`566PID-3523531
comments I----- --- -
The, system, is sized for 4 bedrooms with a maximum occupancy o8 persons (2 per bedroom);'fora total . estimated fiqW of;400
gpd,. New: ST, filter, and 7x8'lon.g'DF installed.. No Violations, system ok . to cover. Contractor.notified onsite, Needs ,final'in.060tkon
for flied system:and . final site,gradin.g.
Final systbrn apOroiV66w Contractor and :building d6p&trWfdmailedl fin,11 apprqvaj.
DH 4016., 08 ' )Oa (obboletes all previous editi6fts which nay not be; used), Page 2 of 3,
'Incorporated: 64E-6.003,:PAC. i
EH Databas.e v 1.0.1 AP1334109