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Home My WebLink About1108-0318-SEWAGE CONSTRUCTION PERMITSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT PERMIT #:56-SF-1351662 APPLICATION # : qP 1036808 DATE PAID: I FEE PAID: RECEIPT #: DOCUMENT #: PR847027 CONSTRUCTION PERMIT FOR: OSTDS New 11 1 1 . L . t., 1 1 0 APPLICANT: George and Susan Pantuso PROPERTY ADDRESS: 3415 S. Indian Romer pr Fort Pierce, FL 34979, LOT: 3 BLOCK: SUBDIVISION: PROPERTY ID #: 2426-133-0001-000-0 [ SECTxON, TOWNSHIP, RANGE, PARCEL NUMBER] OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECT1 381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANI SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACT WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY 7 PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND V01 ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERP STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ 1,500 l GALLONS / GPD Septic CAPACITY A [ ] GALLONS / GPD 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 [ 875 l SQUARE FEET SYSTEM R [ ] SQUARE FEET N/A / SYSTEM A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [X] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: TOP OF IRON ROD EL 42.22 NAVD I ELEVATION OF PROPOSED SYSTEM SITE [ 22.001E INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 52.0011 INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ ] INCHES The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E-6.013(3)(0, FAC. T Not to have more than 18" cover over top of drainfield H E R I SPECIFICATIONS BY: James C Duncan TITLE: Environmental Specialist II i APPROVED BY: TITLE,: Environmental S ecialist IIP St. Lucie c: DATE ISSUED: 06/09/20 EXPIRATION DATE: 12/09/2012 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 v 1.1.4 AP1036808 SE845910 r STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM O"E'' APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: New System [ J Existing System [ ] Holding Tank Repair [ ]. Abandonment [ ] Temporary APPLICANT: (eo rqe Q qc( 3U6 GtA -b• AGENT: i Zala5k f orKes the. / 61-u6r. A i PERMI NO o `' DATE PAID: FEE PAID: i RECEIPT #: Innovative TELEPHONE : -S(v/- T %/ - i / 1 f MAILING ADDRESS : I3 bD / . / / C1 / "C ` / ' `- ` LOe,,6 aln2 6 euc_ .1_ rk 33 j4o 4 a:¢axacacaa¢aacac¢ac¢a¢¢xaxac¢ac¢aa¢aaa¢¢aamcaxaaaaa¢ac¢xccxc¢¢acnaa¢maa¢aac¢mcc¢aaccaa TO BE COMPLETRD BY'APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE CONSTRUCTE BY A PERSON LICENSED PURSUANT TO 489.105(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. sa¢aaa¢acsacaa¢ac¢ac¢ac¢acaaa¢¢c¢¢aa¢¢a¢aac¢¢aocc¢a¢¢ac¢¢aaxaac¢vxxacaa¢mmcc¢aac¢¢aa¢aaa¢a PROPERTY INFORMATION ry,/ LOT: 3 BLOCK: 3 6 SUBDIVISION: PLATTED: / 7"9 PROPERTY ID #: , YI & - /33 - DOD - 000- O ZONING: I/M OR EQUIVALENT: [ Y / N ] q. otl2592 PROPERTY SIZE: ACRES WATER SUPPLY: [V/1 PRIVATE PUBLIC [ I<¢2000GPD [ ]>200`0GPD IS,SEWER AVAILABLE AS PER 381.0065, FS? [ Y / N ] DISTANCE TO SEWER: 7J FT PROPERTY ADDRESS: 3 J. 3Y9-/9 DIRECTIONS TO PROPERTY: BUILDING INFORMATION [ V] RESIDENTIAL. [ ] COMMERCIAL Unit Type of No Establishment 2. 3 4 Floor/Equ SIGNATURE: DH 4015, 08/09 (Obsoletes P. Incorporated 64E-6.001, FAC No. of Building Commercial/Institutional, System Design Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC 17 Other (Specify) ( DATE: 6-us editions which may not be used) Page 1 of 4 a STATE . OF FLORIDA APPLICATION # AP1036f DEPARTMENT OF HEALTH PERMIT # 56-SF-1351 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # .SE845910 SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: George and Susan Pantuso CONTRACTOR / AGENT: LOT: 3 Dave M. Jones BLOCK: SUBDIVISION: ID# : 2426--133-0001-000-0 TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS Mt 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: 4.06 ACRE: TOTAL ESTIMATED SEWAGE FLOW: 700 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER -TABLE 2 AUTHORIZED SEWAGE FLOW: 6090.01 GALLONS.PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE UNOBSTRUCTED AREA AVAILABLE: 1860.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1750.00 SQF4 BENCHMARK/REFERENCE POINT LOCATION: TOP OF IRON ROD EL 42.22 NAVD ELEVATION OF PROPOSED SYSTEM SITE 22.00 [ INCHES / FT ] [ ABOVE / BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: 600 FT DITCHES/SWALES: N/A FT NORMALLY WET: [ ]YES [X]1` WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: 177 FT NON -POTABLE: N/A I BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: N/A I SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]N 10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD ]' SITE ELEVATION: FT [ MSL / NGVL SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES:St. Munsell #/Color Lucie sand' Texture Depth 1OYR 4/1 Fine Sand 0 To 10 1 OYR 7/1 Sand 10 To 40 1 OYR 7/1 Sand 40 To 60 1 OYR 8/6 Sand 60 To 72 USDA SOIL SERIES:St. Munsell #/Color Lucie sand Texture Depth 1 OYR 5/1 Fine Sand 0 To 8 1 OYR 7/1 Sand 8 To 36 1 OYR 8/1 Sand 36 To 72 OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ESTIMATED WET SEASON WATER TABLE ELEVATION: 72 INCHES [ ABOVE / HELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [ ]NO DEPTH: INCHE SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: INCHE DRAINFIELD CONFIGURATION: [X] TRENCH [ ] BED [ ] OTHER (SPECIFY) r REMARKS/ADDITIONAL CRITERIA SITE EVALUATED BY: DATE: 05/31 /2011 Duncan, Jarltef(Title Env lonkfen'tal Sp cS list II) (St Lucie County Environmental Health) DH 4015, 08/09 (Obsoletes previous editions whic may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 LOT: BLOCK: SUBDIVISION: PROPERTY ID'#? 2426 1.33 00001-000-0:. [Section%TowashWParcel:No or.Tax' ID Number]`: TO BE' COMPLETED-'HY ENGINEER ,`HEALTH''DEPARTEMENT EMPLOYEE`,bX.OTHER'QUALIFIED PERSON 'INGINNEERS MUST`"PROVIDE'';.REGISTRATION,.NUMBER AND-'SIGN.AND`:'SEAL•;EACH`,PAGE'.OF;.'SUBMIT TAL:,.'COMPLETE- ALL- .ITEMS , PROPERTY SIZE:,CONFORMS, TO SITE PLAN: [ `YES [ ] NO': NET..USABLE AREA'AVAILABLE U ACRES TOTAL ESTIMATED SEWAGE FLOW %C)Ci GALLONS PEIf DAY [RESIDENCES TABLE 1/.OTHER-TABLE2] AUTHORIZED SEWAGE FLOWG1'Coi GALLONS PER DAY`: [15U0 GPD%ACRE; OR 2500 GPD/ACRE'] UNOBSTRUCTED:"AREA'AVAILASLE j i sD ..' 3QFT UNOB TRUCTED;-AREA REQUIRED• $QFT'. ii' dl Ci"S ll BENCFII+IARK/REFERENCE POINT` LOCATION: /1/.Ini Y2'. ZZ1i/.7 ELEVATION OF, -PROPOSED SYSTEM: -SITE -IS [INCHES/•FT]r [ABOVE/BELOW] ' „NC ,:- /REFERENCE, POINT t; s " THE MINIMUM, -SETBACK WHICH CAN, BE MAINTAINED FROM THE 0 iSED`SYSTEM TO THE FOLLOWING'FEATURES SURFACE WATER tJ FT DITCHE8/SWALES _ FT --"NORMALLY. .WETS [ ]''YES WELLS: VbBLIC• FTC LIMITED IISE FT` PRIV_ATEs G FT NON POTABLE: Z:- FT BUILDING FOUNDAT. ONS S FT . PRO{ ERTY' LINES S FT POTABLE WATER' LINES SITE SUBJECT TO "'FREQUENT'- FLOODING.; [A' ICES, _ [ XJ: NO 1O' • YEAR<. FLOODING? [ ] YES [ X] NO 10 'YEAR FLOOD=ELEVATION'°FOX-SITE.'•'.•. =• -:FT,SITE:.ELEVATION: FT' MSL/,NGVD t y SOIL PROFILE INFORMATION SITE 1 SOIL .PROFILE INFORMATION SITE.;2 MUNSELL #/COLOR' TEXTURE DEPTH „' .,' .MUNSE=L;'#/COLOR TEXTURE DEPTH 2/2 "FS: "`: "p :T0',8" 10,' YR :;"•'S/1 FS 0 TO',?10" lO. YR. ' T/2 FS A`, T0 22" 10' YR 7/?. FS 1U TO 24" , 10 'YR 8/1 . - FS 22 ,To 24 TO`120" TO TO. _ TO To 9, TO , TO TO USDA SOIL -SERIES: 42-St:"'Lucie-Sarid USDA SOIL SERIES 42- Lucie Sarid' OBSERVED WATER,TABLE. 12~0+. INCHES [ABOVE /BELOW]'; EXISTING GRADE TYPEajPERCHED /`APPARENT) ESTIMATED WET ---SEASON, TABLE ELEVATION. 120+ } `.INCHR [A80VE /."BELOW EXISTING`GRADE }. HIGH :WATER TABLE. VEGETATION .;[ ] YES [X,] NO ' ;MOTTLING [ '>] YES [X] 'NO DEPTH INCHES r SOIL,TEXTURE/.LOADING RATE FOR SYSTEM"SIZING DEPTH OF `EXCAVATION: INCHES ` DRAINFIELD CONFIGURATION'e [ ]:'"'TRENCH 's ''`[ l4 BED I ' I OTHER `(SPECIFY) a 77, REMRRKS/ADDITIONAL CRITERIA r 7 SITE EVALUATED BY D TE Ma '2' 201L! fir to Paul'C MartinEA Y ' t r.44GaiS,_:oe/o9 (oba'vyJw/ lotus previous.editions-which:roar aotba A. '+ncarporated 64E6001,.FAC F Page 3 of 4 s PERMIT APPLICATION TO CONSTRUCT REPAI:RMODIFY, M. OR ABANDON A WELL St. Lucie County Health Department This form must be completed by the Environmental Health - Water Programs certified well contractor for approval 5150 NW Milner Drive Port St. Lucie, FL 34983 prior to well construction. . Phone: (772) 873-4931 Fax: (772) 873-4893 9. Imo' eb q c '- a ja( Musa PL 7 Owner or Legaf Name of Pro erty gqwner // 2. .5415 g - lh di k& Ki ve Well Permit #:t OSTDS Permit Fee AmountDatePaid: WUP #: n-luso Po%a /1/0Al9 r r Bailing Vi Well Location (Street Address and Directions) 3. 24 35 City / State ZipAeaCe-, Al- 24479 Owner Phone No. - City/ Zip or 4d V toR'6 410S FEc A2, 4/ HP -AS Aweift RlurD Well Drilling Contractor Driller Mailing Address I 'City/State Zip Driller Phone No. Driller Fax No. 5. PROPOSED WELL:: New Replacement Abandonment Repair Other: 6. WELL TYPE: ®Single Family Drinking Single Family Irrigation DOH Public Drinking (> Duplex) < 15 Service Connections/Serves less than 25 people/ or no oral consumption) - WUP Required, Duplex N/A DEP Public Drinking (> 15 Service Connections or Serves 25 people or more) - WUP Required Commercial Irrigation - WUP Required . Monitor-Qry • Other (Explain): 7. SITE IS ON: SEWER ZNJ SEPTIC PROPOSED DISTANCE TO CLOSEST SEPTIC OR PUBLIC SEWER LINE: 7 8. CUP/WUP: Is a Water Use Permit (WUP) required? YES ONO (If YES WUP must be attached) 9. CONSTRUCTION METHOD: 19 Rotary Cable Tool Other (Explain): 10. GROUTING METHOD: IRBentonite 19cement Other (Explain): 11. WELL CONSTRUCTION: FYfPVC Blk-Steel Galvanized Other (Explain): 12. CASING DIAMETER (SIZE): 3!f 13. ESTIMATED: TOTAL DEPTH SCREEN INTERVAL FROM TOO 14. PERMIT CONDITIONS: Contact St. Lucie County Health Department (SLCHD) the day before initiating drilling or abandonment operations and provide the driller name, permit number, and estimated time drilling or abandonment will begin (Please contact an inspector directly 24 hours prior to drilling all public drinking water wells). If construction does not occur and SLCHD is not notified and an SLCHD inspector visits the site on or after the estimated time, a reinspection fee will be assessed. Detailed Site plan must be attached and show the proposed well location and distances to onsite building structures, property lines, all onsite and neighboring septic systems and/or sewer lines or sewer systems, and all other applicable setbacks per Florida Statutes and Florida Administrative Code. This permit must be available at the well site during drilling or abandonment operations 15. WELL CONTRACTOR PERMIT AGREEMENT: ; OWNER/AGENT PERMIT AGREEMENT: I herby certifyihat I will comply with the applicable rules of Title 40, Florida Administrative Code, and that I certify that I am the owner of the property, that.the information awaterusepermitorartificialrechargepermit, if needed, will be obtained prior to commencement of well provided is accurate, and that I am aware of my responsibilities under construction. I also certi that backs referenced in Rule 40E-3, Florida Administrative Code (FAC), ; Chapter 373, Florida Statutes, to maintain or properly abandon this 64E-8; FAC, and 2-5 , F , will a maintained. If above setbacks cannot be maintained a variance well; or, I clarify that I am the agen the owner, that the information applicationwiaieforandnedpriortodrilling. I further certify that all information provided on , provided is urate, and that I ve in need the owner of his thisappliaticutondatIillobtainnecessaryapprovalfromotherfederal, state, or local ; respons' Ilities as sta bov . Owner rise is to personnel of the govegimenelicdorepomustbesubmittedtotheDistrictandthedelegatedencyw' In DOH a r r sent ive ce s to the I site. 30darrillinrthemtitiration, w ich er cc rs first. G( Signature of Well Contractor License No. Date Owners or.Age nature Date o............................ DO NOT WRITE BELOW THIS LINE - FOR OFFICIAL USE ONLY ............................................ THIS PERMIT IS NOT VALID UNTIL PROPERLY SIGNED BY AUTHORIZED OFFICER OR REPRESENTATIVE OF THE ST. LUCIE COUNTY HEALTH DEPARTMENT. PER IT IS VALID FOR 180 DAYS FRO DAT OF ISSUANCE 1. Rgrmit Approved By: n, 1 PRINT A _ _._._._._ _ _ _MESIGNATU_ Issue Date:. .. Distance to closest septic system or sewer line: Well Construction Method: Grout Material: Inspectors Comments: Approved By: Date: SLCHD Rev 7/13/07 SIGNATURE ct toJZavrenQ QGvtPtnr.