HomeMy WebLinkAboutD O H SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT - 12-11-98PERMIT , # .. .. ,
J� STATE OF FLORIDA
DATE PAID
DEPARTMENT OF"HEALTH
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ONSITE SEWAGE DISPOSAL ' SYSTEM FEE PAID
APPLICATION FOR CONSTRUCTION PE" COu!�`� RECEIPT # ;
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: Authority:. Chapter 381,. FS A Ch er lOD 6FAC
}tpPLICATION FOR:' Tem ora n
PEx erimetal -
[ X ] New System [ ] Existing System [ J Holding Tank L l P/ ;. � c..." •.
Other S ecifyj
[ ] Repair. [ ] Abandonment [ l (p r
.: ,TELEPHONE ..�ti
APPLIAM
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AGENT PORT ST LUC I E PROPERT I ESo ... I NC t
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MAILING ADDRESS i -
I- 358 N E Genesee St Port St. Lucie, -
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fIortda 34983 -,
TO BE .COMPLETED BY APPLICANT OR APPLICANT S AUTHORIZED ".AGENT ATTACH--BU>�ING�lND'ITbaSCALE
SITE .PLAN ,SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER lOD 6, FLORIDA ADMINI'STiA2`T�'EuEOOi��''1%`
--- - - - _-~-______- -- _----- Cyi LEGAL` DESCRIPTION OR DEED] ;
PROPERTY INFORMATION [IF. LOT IS NOT IN A RECORDED SUBDIVISION, ATTA
LOT: j BLOCK SUBDIVISION: I�ATEt`OF 3 5 79
16 The Woodlands Subdivision SUBDIVISION
PROPERTY ID [Section/Townshsp/Range%Parcel No:: J 6ZONINi� ' �Y
.7 r -�-�-
PROPERTY SIZE: ACRES [Sgft 43560] PROPERTY WAITER SUPPL7P: 1[ X ] PRIVATE }
43,554
PROPERTY STREET 'ADDRESS: �� `
Woodlands°'Drive, Ft. fierce; -Florida
DIRECTIONS TO�I PROPERTY:' See' attached site map' �•.
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q�ERCTAIi --
BUILDING INFORMATION ::.[ X ] . RESIDENTIAL : -_
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--
o� Activ t
Na ___o_ Building— #eYso>ss----tsvnes
Unit. .Type. of _..5ed __For__Comm�rcial Only
No Establishm"erit" -"- -- _-_BedrGoms ;Area So ft T�
1 1 Story r, es i.d ce - ---- - - -.,+ j 2016. 4 -- -- .- -_
gin"
2 -- ----- _ --- - -
3 ... . _ s .`xti... t : 1 ai.S �;%,... _. 7. .:•:'si"fi'a.e4 ] ��a °YTf : •):` __._. '+ >,...- ,._ :.
� 4":`it t� r A.3 ?' f .�
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4 zi
+ [ 11 Garbage Grinders/Disposals " [ 0 ].;c Spaof s/H 1 - _
0 Floor E ui meat Drains.'
Y} r�,
[ 0 ]. Ultra-lolu Volume -'Flush --Toilets [ 0 ] -Othher (Spec Nf "+t ;
APPLICANT.'S SIGNATURE:
1
i Page of 3
DH 4015, 10/96 (Replaces HRS-H Form 40.15 [page 11 which maybe used)
(Stock Number: 5744-001-4015-1).