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Home My WebLink AboutD O H PAPERWORKn PROPERTY IID #: 1414-701-0123-000-4 LOT: A BLOCK: 14 SUBDIVISION: Queens Cove [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 [ 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 [ 500 ] SQUARE FEET Drainfield New SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [x] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION of BENCHMARK: BM FND PK no ID elev 3.04 I ELEVATION OF PROPOSED SYSTEM SITE [ 4.00 it INCHES FT ][ ABOVE BELOW] BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 1.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L Di 0 T H E R ,L REQUIRED: [ 13.0[)] INCHES EXCAVATION REQUIRED: L J LNUnnn ie system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 10 gp& ie licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with 64E-6i 013(3)(f), FAC. SPECIFICATIONS BY: Brian J Ingram TITLE: Environmental Specialist II APPROVED BY: 1 /{' / TITLE: Environmental Supervisor I St. Lucie CHD Dianna S May DATE ISSUED: 10/15/2018 EXPIRATION DATE: 04/15/2020 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, PAC Page 1 of 3 S¢•SF' I 9n p STATE OF FLORIDA DEPARTMENT OF HEALTH PERMIT NO. DATE PAID: coils ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: 2-"Fob SYSTEM RECEIPT #: APPLICATION FOR CONSTRUCTION PERMIT APPLICAR�ION FOR: [V/] New System [ ] Existing System [ ] Holding Tank [ I Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT:� AGENT: TELEPHONE: MAILING DRESS: (` � !.'YLt'� -)L) e:Ei RF.t�� x6:t L�i /,-eei 4L. 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 IINFORMATION LOT: .A! BLOCK: SUBDIVISION: Out;,--i �' Cey6 lhoif l PLATTED: � .�lGi�� eSe PROPERTY ID #: I71Yl-0j�23 ZONING: XF-Y-6sVAlC-/M OR EQUIVALENT: [ Y/N ] PROPERTY SIZE: *As ACRES WATER SUPPLY: [ ] PRIVATE PUBL C? [ ]<=2000(;PD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381.00.65, FS? [ Y / N0 ] pp-- DISTANCE TO SEWER: � -Fi- PROPERTY ADDRESS: �S %aa�J1(Q F' a L[,, 4)z F-rf. . 3l l `0lm j, DIRECTIONS TO PROPERTY: V A I A L� 3" Cc � I �e , � �� GC J l : �L' 1 D YL 6.,'ze ee io-.r keel d � BUILDING INFO Unit Type of No 9stabli 2 3 4 [ ] RESIDENTIAL [ ] COMMERCIAL No. of Building Commercial/Institutional System Design Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC �v .a i [ I Floor/EquipzRgAt--grains [ I Other (Specify) / ,/ DATE: SIGNATURE . -I �/:<-::• _ � �� ,r��L�Gr/ DH 4015, 68/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC Page 1 of 4 ita71(I�.=.a HEALTH PAYING ON: RECEIVED FROM: PAYMENT FORM: St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 PERMIT #: 56-SF-1842936 BILL HOC #:56-BID-3995568 CONSTRUCTION APPLICATION #: AP1367873 Paul Sasseville AMOUNT PAID: $ 400.00 CHECK 1530 PAYMENT DATE: 10/08/2018 MAIL TO: Paul Sasseville FACILITY fyAME PROPERTYI LOCATION: 25 Majestic Way Fort Pierce, FL 34949 A Lot: Pro pert ID: 1414-701-0123-000-4 EXPLANATION or DESCRIPTION: Block: 128 - OSTDS Construction System Inspection Research Fee -1 - Surcharge (All) -1 - OSTDS New Permit Surcharge -1 - OSTDS Construction Application and Plan Review,New 126 - OSTDS Construction Permit (New or Mod, Amendment) 127 - OS DS Construction System Inspection 133 - OS ADS Construction Reinspection RECEIVED BY: MontanezNM 14 QUANTITY FEE 1 $ 5.00 1 $ 15.00 1 $ 100.00 1. $ 100.00 1 $ 55.00 1 $ 75.00 1 $ 50.00 AUDIT CONTROL NO. 56-PID-3765742 admit proce admit NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an iistrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such edings are governed by'Rule 28-106, Florida Administrative Code. A petition for iistrative hearing must be in writing and must be received by the Agency Clerk for the rtment, within twenty-one (21) days from the receipt of this order. The address of the ;y Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency 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 tute 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 govened 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. o Y STATE OF FLORIDA APPLICATION # DEPARTMENT OF HEALTH PERMIT # 56-SF-1842936 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE1117148 SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT:1 Paul Sasseville CONTRACTOR / AGENT: Paul Sasseville LOT: A BLOCK: 14 SUBDIVISION: Queens Cove ID#: 1414-701-0123-000-4 TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST 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: 0.25 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ] AUTHORIZEDi SEWAGE FLOW: 625.00 GALLONS PER DAY [ 1500 GPD/ACRE OR 1 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 750.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: BM FND PK no ID elev 3.04 ELEVATION OF PROPOSED SYSTEM SITE 4.00 [ INCHES / FT ] [ABOVE / BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: 50 FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [X]NO I WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 10 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 SOTT. PROFTLF. TNFORMATTON STTF. 1. USDA SOIL SERIES:Arents, organic substratum Munsell #!Color Texture Depth 10YR 312 'Sand 0 To 3 10YR 6/3 Sand 3 To 25 10YR 6/2 Sand 19 To 37 7.5R 5/8 CMN/PRM RF 29 To 37 5PB 6/1 Sand 37 To 68 HOLE CAVING Refusal .68 To 72 COTT. PRAFTT.V.. TNFORMATTON STTE 2 USDA SOIL SERIES:Arents, organic substratum Munseli #/Color Texture Depth 10YR 3/2 Sand 0 To 4 10YR 5/3 Sand 4 To 26 10YR 6/2 Sand 21 To 38 7.5YR 518 CMN/PRM RF 31 To 38 5PB 611 Sand 38 To 65 HOLE CAVING Refusal 65 To 72 OBSERVED WATER TABLE: 41.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: i ESTIMATED WET SEASON WATER TABLE ELEVATION: 29 INCHES [ ABOVE HIGH WATER TABLE VEGETATION: [ ]YES( [X]NO MOTTLING: [X]YES [ ]NO SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DRAINFIELD CONFIGURATION: [ ] TRENCH [X ] BED REMARKS/ADDITIONAL CRITERIA WSWT determined using USDA WSS and soil borings. 7.6YR518 CMN PROM RFs >2% in >60% 10YR612 matrix starting 29" In S61. SB1 4" above BM. SB2 8" above BM. i7 [ PERCHED / APPARENT ] EXISTING GRADE DEPTH: 29.00 INCHES Sand/0.60 DEPTH OF EXCAVATION [ ] OTHER (SPECIFY) SITE EVALUATED BY: Ingram, Brian (Title: Enyirdnmental Specialist II) (ENVIRONMENTAL HEALTH) DH 4015., 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, PAC INCHES DATE: 05/15/2018 Page 3 of 4