HomeMy WebLinkAboutD O H TREATMENT - DISPOSAL CONSTRUCTION PERMIT 5-15-06STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT MARNNED
BY
St Lucie County
:ONSTRUC ION PERMIT FOR:
[ ]Newl System [ ]Existing System [ ]Holding Tank [
[ X ]Repair [ ]Abandonment [ ]Temporary [
APPLICANT}: Rose, Jeff
CENTRAX #: 56-SF-08844
DATE PAID:
FEE PAID $
RECEIPT
OSTDSNBR 06-6200- -R
] Innovative Other
AGENT:PAUL ,REVELS
PROPERTY STREET ADDRESS: 3343 S Indian River Dr Fort Pierce FL 34982
LOT: BLOCK: SUBDIVISION:
[Section/Township/Range/Parcel No.]
PROPERTY IID #: --- [OR TAX ID NUMBER]
SYSTEM MUST
DEPARTMENT
PERIOD.
REQUIRE
PERMIT BEING
COMPLIANCE
BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E-6,FAC
APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
�ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, j
HE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS'
MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM
WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT.
SYSTEM DESIGN
I
AND SPECIFICATIONS
T [ 1900
]Gallons SEPTIC TANK MULTI-CHAMBERED/IN SERIES: [Y ].
A [ 0
]Gallons MULTI-CHAMBERED/IN SERIES: [Y ]
N [ 0
]GALLONS GREASE INTERCEPTOR CAPACITY
K [ 0
]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ 10 ]DOSES PER 24 HRS ## PUMPS[ 0 ]
D [ 750
]SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ 0
]SQUARE FEET SYSTEM
A TYPE SYSTEM:
[ Y ]STANDARD [ N ]FILLED [ N ]MOUND [ N ]
I' CONFIGURATION:
[ Y ]TRENCH [ N ]BED [ N ]
N
F LOCAT{ON
TO BENCHMARK: Top of Existing Driveway Adiacent To Proposed Septic System
I ELEVATION
OF PROPOSED SYSTEM SITE [ ] [ INCHES'] [ BELOW] BENCHMARK/REFERENCE POINT
E BOTTOM
OF DRAINFIELD TO BE [ 30.0 ] [ INCHES ] [ BELOW] BENCHMARK/REFERENCE POINT
L
D FILL
REQUIRED:[ 0.0 ]INCHES EXCAVATION REQUIRED: [ 0.0 ] INCHES
OTHER RE
The lice
category
ed contractor installing the system is responsible for
f tank in accordance with s. 64E-6.013(3)(f), FAC.
Install replacement septic system meeting all 64E-6 FAC requirements.
'There's to be 6"-18" of cover on top of drainfield.
Must submit septic tank abandonment cert. prior to inspection.
SPECIFICATIONS BY:POLISSKY, JODI
APPROVED BY: Polissky, Jodi
- _J?
DATE ISSUED: 5%15/06
TITLE:
minimum
TITLE: Environmental Spec St. Lucie
EXPIRATION DATE: 8/13/06
CHD
i
DH 4016, 03%97 (Obsoletes previous editions which may not be used)
(Stock Number: 5744-001-4016-0) [ostds_cons-4016-11 Page 1 of 2
STATE OF FLORIDA CENTRAX #: 56-SF-08844
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID : $
CONSTRUCTION PERMIT RECEIPT
OSTDSNBR : 06-0200- -R
:ONSTAUCTIION PERMIT FOR:
[" ]New System [ ]Existing System [ ]Holding Tank
[ X ]Repair [ ]Abandonment [ ]Temporary
PLICANTI: Rose, Jeff
PROPERTY
LOT:
PROPERTY
SYSTEM M
PERIOD.
REQUIRE T
PERMIT BE
COMPLIANC
SYSTEM DE
T [ 1900
A [ 0
N [ 0
K [ 0
D .[ 750
R [ 0
A TYPE
I CONFIG
N
F LOCAT7
I- ELEVAI
E BOTTON
L
D FILL F
[ ] Innovative Other
AGENT:PAUL REVELS
BET ADDRESS: 3343 S Indian River Dr Fort Pierce FL 34982
BLOCK: SUBDIVISION:
[Section/Township/Range/Parcel No.]
#: --- [OR TAX ID NUMBER]
ST BF,CONSTRUCTEDIN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E=6;FAC =-
T APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT,
HE APPLICANT TO MODIFY THE PERMIT APPLICATION.,SUCH MODIFICATIONS MAY RESULT IN THIS]
ING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM
E WITH OTHER FEDERAL, STATE OR_ LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT.
SIGN AND SPECIFICATIONS
]Gallons SEPTIC TANK MULTI-CHAMBERED/IN SERIES: [Y ]
]Gallons MULTI-CHAMBERED/IN SERIES: [Y ]
]GALLONS GREASE INTERCEPTOR CAPACITY
]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 )
]SQUARE FEET PRIMARY DRAINFIELD SYSTEM
]SQUARE FEET SYSTEM
YSTEM: [ Y ]STANDARD [ N ]FILLED. [ N ]MOUND [ N ]
URATION: [ Y ]TRENCH [ N ]BED [ N ]
JN TO BENCHMARK: Ton of Existing Driveway Adlacent To Proposed Septic System
ION OF PROPOSED SYSTEM SITE [ ] [ INCHES ] [ BELOW] BENCHMARK/REFERENCE POINT
OF DRAINFIELD TO BE [ 30.0 ] [ INCHES ] [ BELOW]BENCHMARK/REFERENCE POINT
: [ 0.0 ] INCHES
EXCAVATION REQUIRED: [ 0.0 ] INCHES
The licensed contractor installing the system is responsible for installing
category pf tank in accordance with s. 64E-6.013(3)(f); FAC.
Install replacement septic system meeting all 64E-6 PAC requirements.
There's to be 6n-18° of cover on top of drainfield.
Must submit septic tank abandonment cert. prior to inspection.
SPECIFICATIONS BY:POLISSKY, JODI TITLE:.
APPROVED BY: Polissky, Jodi TITLE:` Environmental Spec St. Lucie CHD
DATE ISSLPED: 5/15/06 EXPIRATION DATE: 8/13/06
DH 4016, 03/97 (obsoletes previous editions which may not be used)
Page 1 Of 2
(Stock Number: 5744-001-4016-0) [ostds_cons_4016-11