HomeMy WebLinkAboutD O H ONSITE SEWAGE TREATMENT AND DISPOSALSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CEALEDFASTENERS ORATi'ACHMEWS IJECEIVE®
ARE THE RESPONSIBUTY OF THE
CONTRACTOR OR RECORD O C T I 1 i v 1 i
PERMIT #:56-SF-1876402
APPLICATION #: AP1363696
DATE PAID:
FEE PAID:
RECEIPT #':
DOCUMENT # : PR1166498
APPLICANT: Darren Reed
PROPERTY (ADDRESS: Slash Pine Trl Fort Pierce FL 34951 F I I. J.Z-,ude counh
LOT: I BLOCK: SUBDIVISION:
PROPERTY ID #: 1407-313-0020-000-9 [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 r IN. THIS PERMIT BEING MADE NULL AND VOID.
ISSUANCE OF THIS. PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, ORI LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 900 ] GALLONS / GPD Septic new 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 [ 375 ] SQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [X] FILLED [] MOUND [ ]
I CONFIGURATION: [X] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: 16d nail in PP W of system. 35" above nail in Rd, S
i
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
line extended W.
[ 38.00][ INCHES FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT
[ 39.00][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT•
D FILL REQUIRED: [17.001 INCHES EXCAVATION REQUIRED: [ ] INCHES
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
O 300 gpd{
T The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with
H s. 64E-6L013(3)(% FAC.
E
R
SPECIFICATIONS BY: Brian J Ingyqum TITLE: Environmental Specialist SI
APPROVED BY: ITLE: Environmental Specialist II St. Lucie CHD
I Brian.J Ing
DATE ISSUED: 10/08/2018 EXPIRATION DATE: 04/08/2020
DH 4016, 0'8/09 (Obsoletes.all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1363696 SE1116473
NOTICE OF RIGHTS
admiA party whose substantial interest is affected by this order may petition for an
nistrative 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 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
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
ordeF'.
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.
a.
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
HEALTH
PAYING ON: ER IT#:56-SF-1876402 13ILL DOC #:56-BID-3962435 CONSTRUCTION APPLICATION #:AP1363696
RECEIVED FROM: 'Dave Golden Homes AMOUNT PAID: $ 51.5.00
PAYMENT FORM- CHECK 25849 PAYMENT DATE: 09/11/2018
MAIL TO:
FACILITY IS
PROPERTI
128 -
-1 - S
-1 - C
-1 - C
123 -
126 -
127 -
133 -
Fort
Lot:
Reed
WE:
LOCATION:
i Pine Trl
erce. FL 34951
Block:
Irty ID: 1407-313-0020-000-9
EXPLANATION or DESCRIPTION:
QUANTITY
FEE
S Construction System Inspection Research Fee
1
$
5.00
ge (All)
1
$
15.00
New Permit Surcharge
1
$
100.00
Construction Application and Plan Review,New
1
$
100.00
S Construction Site Evaluation
1
$
115.00
S Construction Permit (New or Mod, Amendment)
1
$
55.00
S Construction System Inspection
1
$
75.00
S Construction Reinspection
1
$
50.00
EIVED BY: WhighamJL
AUDIT CONTROL NO. 56-PID-3710386