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Home My WebLink AboutD O H ADDITIONAL PAPERWORKPERMIT # : 56-SF-1877440 APPLICATION # : AP 1364397 STATE OF FLORIDA DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND. DISPOSAL FEE PAID: SYSTEM CONSTRUCTION PERMIT FOR: APPLICANT: : James Busby If PROPERTY ADDRESS: ' 18700 Mach One Dr Port Saint LOT: 4 BLOCK: 1 RECEIPT #: DOCUMENT # : PR1166450 FILE COPY OSTDS New 4��A FL 34987 I SUBDIVISION: Aero Acres PROPERTY ID # : 3215-801-0011-000-8 [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 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 [ 1,050 ] 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 [ 1500 ] SQUARE FEET Drainfield new SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE (SYSTEM: [ ] STANDARD [ ] FILLED DC] MOUND I CONFIGURATION: p[] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: site BM IR in I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L CL of Rd, W property line extended S 7.00 ]( INCHES FT ][ABOVE LBELOW j BENCHMARK/REFERENCE POINT 5.00 ][ INCHES FT ](ABOVE BELOW BENCHMARK/REFERENCE POINT D'FILL REQUIRED: [20.001 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 0 400 gpd. T The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with H s. 64E-6.013(3)(f), FAC. E R SPECIFICATIONS BY:- Brian J Ingr_amj TITLE: Environmental Specialist II APPROVED BY: /, �. � � : Environmental Specialist ,II ' St: Lucie . CHD Brian J Ingr DATE ISSUED: 10/08/2018 EXPIRATION DATE: 04/08/2020 DH 4016I, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, PAC Page 1 of 3 v 1.1.4 AP1364397 SE1116407 NOTICE OF RIGHTS A party whose substantial- interest is affected by this order may petition for an administrative hearing pursuant to sections 120.669 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 fling 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. 5^ - HEALTH PAYING ON: I RECEIVED FROM: PAYMENT FORM: St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 PERMIT#: 56-SF-1877440 BILL DOC #:56-BID-3966477 CONSTRUCTION APPLICATION #: AP1364397 Craig S. Helseth AMOUNT PAID: $ 515.00 CHECK 1233 PAYMENT DATE: 09/14/2018 i MAIL TO: James Busby If FACILITY NAME: PROPERTY_ LOCATION: 118700 Mach One Dr Port Saint Lucie, FL 34987 Lot: 4 Block: 1 ,Property ID: 3215-801-0011-000-8 EXPLANATION or DESCRIPTION: QUANTITY FEE 128 - IOSTDS 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 I 123 -,OSTDS Construction Site Evaluation 1 $ 115.00 126 - OSTDS Construction Permit (New or Mod, Amendment) 1 $ 55.00 I 127 - OSTDS Construction System Inspection 1 $ 75.00 133 - OSTDS Construction Reinspection 1 $ 50.00 RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-3718284 E �STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM WEI APPLICATION FOR CONSTRUCTION PERMIT I APPLICATION FOR: New System [ ] Existing System [ ] Holding Tank [ ] Repair [ ] Abandonment [, ] Temporary PERMIT NO. 9'1Y`/D DATE PAID: FEE PAID: (?l;�, VX33 RECEIPT #: [ . ] Innovative APPLICANT:�� PT - I. AGENT: Cf'Y,ilc� J r'r�� +� TELEPHONE: MAILING ADDRESS.: 4Vc3�7�7 I TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE CONSTRUCTED 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. PROPERTY INFORMATION LOT BLOCK: SUBDIVISION:PLATTED: PROPERTY ID #:/— Q�$//-QQ(jNING: r �`r I/M OR EQUIVALENT: Y/N ] I PROPERTY SIZE: ACRES WATER SUPPLY: [/PRIVATE PUBLIC [ ]¢=2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: Ai%700 1V6,--W 4~ ,Q- 3115,9-1 DIRECTIONS TO PROPERTY: - I BUILDING INFORMATION Unit Type of No Establishment 2, 31 4I [ ] Floor I SIGNATURE: DH 4015, 08/09 Ob Incorporated 64E-6 I i [ V] RESIDENTIAL No, of Building Bedrooms Area Sqft [ ] COMMERCIAL Commercial/Institutional System Design Table 1., Chapter 64E-6, FAC Drains [ ] Other ,(Specify) oletes previous editions which may -not be used) 001, PAC DATE: Page 1 of 4 LOT: 4 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE'SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION ies Busby II .NT: Craig S. Helseth BLOCK: 1 APPLICATION # AP1364397 PERMIT # 56-SF-1877440 DOCUMENT # SE11-16407 SUBDIVISION: Aero Acres ID#: 3215-801-0011-000-8 TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE oc+nTamnaniTnv WfftMV4 RMn QW-IM 'AWn CF.AT. T2nrT7 DM_F. nF RTTRMTTTAL_ COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 2.03 ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ] 1500 GPD/ACRE OR 2500 GPD/ACRE ] AUTHORIZED SEWAGE FLOW: 3045.01 GALLONS PER DAY [ UNOBSTRUCTED AREA AVAILABLE: 1440.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: site BM IR in cutout, CL of Rd, W property ELEVATION OF PROPOSED SYSTEM SITE 7.00 [ INCHES / FT ] [ ABOVE / line extended S 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 EXINO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 100 FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 75 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO] 10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD QnTT. DRAFTT.W. TNFARMLTTAN CTTF.9 SOIL PROFILE INFORMATION SITE 2 i USDA SOIL SERIES:Pineda sand Munsell #/Color Texture Depth 10YR 3/2 Sand 0 To 15 10YR 5/2 Sand 15 To 35 10YR 5/8 CMN/PRM RF 22 To 35 10YR 612 Sand 35 To 45 10YR 4/3 Sand 45 To 49 10YR 4/2 Loamy Sand 49 To 53 10YR 5/3 -Sandy Loam 53 To 62 10YR 4/2 Sand 62 To 72 I USDA SOIL SERIES:Pineda sand Munsell #/Color Texture Depth 10YR 4/2 Sand 0 To 10 10YR 512 Sand 10 To 36 10YR 5/8 CMN/PRM RF 25 To 35 10YR 6/2 Sand 36 To 41 10YR 3/4 Sand 41 To 53 10YR 4/2 Loamy Sand 53 To 56 10YR 5/4 Sandy Loam 56 To 64 10YR 4/2 Sand 64 To 72 OBSERVED WATER TABLE: 64.00 INCHES [ ABOVE / HELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 22 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 22.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING•: Sand/0.80 DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [X] TRENCH E. ] BED [ ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA 10YR5/8 SB1 7" t iined using USDA WSS and soil borings. PROM RF mottling in 10YR5/2 matrix >2% starting at 22" in S131. BM. SB2 6" below W. 1117 SITE EVALUATED BY: / Ingram, Brian (Title: Vvironmental Specialist II) (ENVIRONMENTAL HEALTH) DN 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC DATE: 09/21/2018 Page 3 of 4 AP1364397 EID1877440 v 1.0.2