HomeMy WebLinkAboutD O H PAPERWORK40 ian, D6P-1 46
STATE OF FLORIDA
DEPARTMENT OF HEALTH
,•�R ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
.cor, wc'r
APPLICATION'#
PERMIT #:56-SF-1.879729
DOCUMENT #: F11 �10731
DATE PAID:'09/24/2018
FEE PAID:515.00
RECEIPT #.56-PID-3736351
APPLICANTI: Jeffrey &'Gina Moore
AGENT: Gem Builders„ Inc
PROPERTY ADDRESS: 1.0651 Pine Needle Dr Fort Pierce, FL 34945 e'�blrv�e�r�
LOT: 14 BLOCK: st Lucie County
SUBDIVISION: Pine Hallow ID#: 2321-802-001.6-000-9
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
[ j
[01]
TANK SIZE 11]:
1090,00 121
[ ]
[ ]
(02]
TANK MATERIAL
Polypropylene
[ 7
[ ]
(03)
OUTLET DEVICE
[ ]
[ ]
[04]
MULTI —CHAMBERED
[ Y N ]
[ I
[ ]
[O5]
OUTLET FILTER
Polylok PL-68
( ]
[ 7
10 6]
LEGEND 1. 70-1.43-11 DC3 2.
[ )
[ ]_
(071
WATERTIGHT
[ ]
[ ]
[08]
LEVEL
[ ]
[ ]
10-91
DEPTH TO LID
[ ]
I
7
7
7
}
7
I
7
l
1
DRAINFIELD INSTALLATION
[101 AREA [i] 509.4 [21 SQFT [ ]
[11] DISTRIBUTION BOX _ 'HEADER X [ )
[121 NUMBER OF DRAINLINES
[13] DRAINLINE SEPARATION
[141 DRAINLINE SLOPE
[1S] DEPTH OF COVER
[161 ELEVATION [ ABOVE /
[17] SYSTEM LOCATION
[18) DOSING PUMPS
1, 5.00 2,
9ELO4l ] BM 15.00
[191 AGGREGATE SIZE
[20]' AGGREGATE EXCESSIVE; FINES
[21] AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
[221 FILL AMOUNT
[231 FILL TEXTURE
[24] EXCAVATION DEPTH
[2,5] AREA REPLACED
(26] REPLACEMENT MATERIAL
Comments:, Comments are on page 2.
SETBACKS
1271
SURFACE WATER 100
FT
[28]'
DITCHES
FT
[29]
PRIVATE'WELLS 100
FT
[30)
P.UBLIC WELLS
FT
[311
IRRIGATION WELLS
FT
[32 j
POTABLE', WATER 75
FT
[331
BUILDING FOUNDATIONS 5
FT'
[34]
PROPERTY LINES 35
FT
[351
OTHER
FT
FILLED / MOUND SYSTEM
[361
DRAINFIELD COVER
(371
SHOULDERS
[38)
SLOPES
[39,]
STABILIZATION 01/22/2019
ADDITIONAL INFORMATION
[ ];
[401
UNOBSTRUCTED AREA
[ j
[41]
STORMWATER RUNOFF
[ 1
[421
ALARMS
[ ]
1431
MAINTENANCE AGREEMENT
[ 7
[441
BUILDING AREA
[ ]
[45']
LOCATION CONFORMS WITH SITE PLAN
( ]
[461
FINAL SITE GRADING
[ )
[47]
CONTRACTOR MICHAEL W STUHR (ASHTO
[ 7
[48)
OTHER INFILTRATOR Quick4 Plus EQ36 LP
ABANDONMENT
[ j [.49) TANK PUMPED
( ] [501 TANK CRUSHED'& FILLED
CONSTRUCTION [ APPROVED ro R St, Lucie CHD DATE: 04/OS/2019
DISAPPROVED Environmental Specialist t Brian.lingram(ENVIRONMENTALHEALTH)
FINAL SYST
EM [ APPROVED / DISAPPROVED ]: Z /� St. LuciQ CHD DATE: 07/22/2019
Environmental Supervisor I lanna S May (Florida Department,of Heal
(Explanation of Violations on following page)
DH 4016, 68/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, PAC Page 2 of 3
;3;za;
•
ILEF
STATE OF FLORIDA
DEPARTMENT OF HEALTH
`tTTa ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
z3 CONSTRUCTION INSPECTION AND FINAL APPROVAL
♦ E
APPLICATION #
PERMIT #:56=SF-1879729
DOCUMENT ,# : FI 1310731
DATE PAID:09/24/2018
FEE PAID:515.00
RECEIPT #:56-PID=3736351.
Violation Number Comment
comments.
The system is sized for 3 bedrooms with a- ,maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300
9pd•
New ST, filter, and 5x9 long DF installed. No violations, system ok to cover.. Contractor notified by phone. Needs final inspection
for moundsystem, gutters, and final site grading.
Final inspection for mound system,,gutters and final site grading satisfactory- no violations observed. Emailed to building
department and contractor. Final inspection performed by Brian Ingram and entered by Dianna May. '
DH 4016, 08/09 (obsoletes all previous editions which may not be used)
Incorporated: 64E 6 003, FAC
Page 2 of 3
x'
�Y. FILE COPY NOV 2 9 2018
<� STATE t5F FLORIDA PERMIT AMICATION TO CONSTRUCT,
CAR G . n2pAik MODIFY, OR ABANDON A WELL
uSouthwest PLEASE FILLPUTALL P.Pt'u FIELDS
flNorthwest (•Denotes Required i'8Q ere Appilcahle)
USt. Johns River
rltermtrrtrelrcanrm�7crrnrcpvm,++kre,camp,e,og
{r 0South Florida(lots rauna,ldtonvanlirlprhotpeaaltapplltatimrto910
"( *� !.'!Suwannee River nppropnatWdnLrgaicdnllthwrtywhetBrtppt!Coble,
❑ DEP
(� n CiDel9�8ted Authority (If Applicable)
{
°V�((fllJroCailop- �R,o7rass�,t�Uad Name
s, r�Z�' tl lc� _,
"Parcel I o (PIN) or Altern (Ci
4.
• action or Land Grant tawrrsttip
8.
1G
UInf`T a,9b57
Unique ID 1
Stipulations Required (See Attaehod)
Quad No. D811f1eatlon NO,_.
UP Application No.
Telephone Number
�(��� �Lot Block U_nl
1.l Check if 62-524.0 Yes No
rlt; on
7. 'Type of Work:IK Construct! n ❑ Repair ❑ Modificallon[] Abandonment _RCOsontorRopalr. Moddcntq
8. -Number of Proposed Wells
`Specify intended Use(a) of Well(s): d
Domestic Landscape brigs 011 ® Agricultural Irrigation ® Site Investigations
Bottled Water Supply M Recreation Area Irrigation Livestock Monitoring
Public Water Supply (Limited USeJOOH) Nursery Irrigation Test
rl Public Water Supply (Community or Non•Community/DEP) Commercialllndustrlal Earth -Coupled Geothermal
Class I Injection Gal( Course Irrigation WAC Supply
HVAC RetUlTL
CT 3 0 2018
Class V injection: ❑ Recharge ❑ CommerelaUfndustdal Disposal ❑ Aquifer Slorage and Recovery Drainage
Remedlation: ❑ Recovery ❑ Air Sparge ❑ Other (llosalb0) in PA(mtiiilCis countv
us
[] Other (D00) ENVI E T
10 "Distance from Septic System if 5 200 ft. _ 11. Faclli�!r
on 12. Estimated Start Date
1VEstimated Well Depth f� ft. 'Estimated Casing Depth Primary Casing Diameter In, Open Hole: From To ____,,,ft.
14. Estimated Screen interval: From r xD To GO- ft. QSC4
1S.•Primary Casing Material. Black Steel Galvanized PVC Stainless Steel �,t� �NNg
Not Cased Other: )
16. Secondary Casing: Telescope Casing Liner Surface Casing Diameter in.
17. Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel er
I& Wethod of Construction, Repair, or Abandonment: Auger Cable Tool Jetted Rotary Sonic
Combination (Two or More Methods) Hand Driven (Wolf Point, Sand Point) Hydraulic mt (Dlrect Push)
Horizontal Drilling Plugged by Approved Method other tooseraw
19. Proposed outing Into al for the Primary, Secondary, and Itionare-631
Fromfa To Seat Material( Benwrilte Neat Cement Other 1
From To Seal Material ( Bentonite a tint other ..�.. _?
From To Seal Material ( Bentonite Neal Cement Other
From To Seal Material ( aentonite Neat Cement Other )
20. Indicate total number of existing wells on site ___ ______ List number of existing unused wells on site
21.1I9 this well or any existin well Or water withd on the owner's contiguous propart covered under a Consumptiv�lW�tar use Permit (CUPNVUP)
or CUPIWUP AppllealloA Yes No If yes. complete Ihe-totiownng: C& VWP No. Malct Well ID No.
22. Latitude' _- I" INS Se
23. Data Obtained From: GP5 `tom/Map Survey Datum: NAD 27lthdap� Y NAD 83 WG5 84
Ihe101rycUNry01t41w�mtr�lYNpilBlanl*lclo,laMotalfti40, IWnf+WunwvWw�,and0�l�wwr. Icu6Mtnttiu�{tCht davule "Am ai iS�t�OtWittlWtflmmilnWOWprepalhcWnJnn { raitualoro
tral`{rmlt ar �9N7�I roclswpu perrlil,Unvedinl,l+a. Uaun or xClW aGtilnad glor lo0oitmtnccmcMafmO 1{+Pw► {
bm,�h -a, k R=ra!e an011101 Iwo00111 Old AploW 070WMr,91111 kltOffOl�tlon picv dvG k�ia.��•..,�,,.., �la�. u�W1�na Del �Atrnmlty {eN6i
by
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By � /T .a"'g 10suoDato l" 3_f_�Jl r ExprratlanData
HydrdlollM Approval
110 412
Fee Received $ ` Receipt No. Check No. -- --
THIS PERMIT IS NOT VALID UNTIL PROPERLY SIGNED BY AN AUTHORIZED OFFiceR OR REPRESENTATIVE OF THE WMD OR DELEGATED AUTHORITY, THE
PERMIT SHALL SE AVAILABLEAT THE WELL SITE DURING ALI. CONSTRUCTION REPAIR, MODIFICATION, on ABANDONMENT ACTIVITIES.
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PERMIT #:56-SF-1879729
STATE OF FLORIDAAPPLICATION #: AP1365772
!.,
µ °"s DEPARTMENT OF HEALTH DATE PAID:
�• ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID:
SYSTEM
5y, y �� RECEIPT #: ,
DOCUMENT # : PR1169146
NOVCFILO
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: J'effrev &
PROPERTY ADDRESS: 10651 Pine Needle Dr Fort Pierce, FL 34945
LOT: 14 1 BLOCK: SUBDIVISION: Pine Hollow
PROPERTY ID #t 2321-802-0016-000=9 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAR ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.006S, 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 ] I GALLONS / GPD Seotic 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 ] SIQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [I MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: TBM1 IR in cutout center of cul-de-sac
I ELEVATION OF!PROPOSED SYSTEM SITE [ 23.001E INCHES FT ][ABOVE BELOW I BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 11.001E INCHES FT ][ABOVE BELOW 3BENCHMARR/REFERENCE POINT
L
D FILL REQUIRED- r 6.00 1 =NCHEs EXEAvATION Rrzo=REn : r 51.00 1 INCHES
O
T
H
E
R
The system is sized for 3 bedrooms with a maximum. occupancy of 6 persons (2 per bedroom), for a total estimated flow of
300 gpd.
The licensed contractor installing the system is responsible for installing the minimum category of; tank in accordance with
s. 64E-6.013(3)(0, FAC.
SPECIFICATIONS
APPROVED BY:
DATE ISSUED:
Brian T
8
TITLE: Environmental Specialist II
TITLE: Environmental Specialist II St. Lucie CHD
DE 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: ¢4E-6.003, FAC
EXPIRATION DATE: 04/30/2020
Page 1 of 3
v 1.1.4
AP1365772
SE1119028
STATE OF .FLORIDA PERMIT- W-/ -7g 72
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
APPLICANT: Jeffrey and Gina Moore AGENT: EDC, Inc
LOT: 14 BLOCK: Unit SUBDIVISION: Pine Hollow
PROPERTY ID # : 2321-802-0016-000-9 [ Section/Township/Parcel No. or Tax ID Number ]
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: V] YES [ ] NO NET USABLE .AREA AVAILABLE: IA3 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [RESIDENCES-TABLEI ]
AUTHORIZED SEWAGE FLOW: 2145 GALLONS PER DAY [1500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1200 SQFT UNOBSTRUCTED AREA REQUIRED: 750 SQFT
BENCHMARK/REFERENCE POINT LOCATION:
ELEVATION OF PROPOSED SYSTEM SITE IS [INCHES/FT ] [ABOVE/BELOW'] BENCHMARK/REFERENCE POINT
THE MINIMUM,SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER:165 FT DITCHES/SWALES:50 FT NORMALLY WET? [ 1 YES W1 NO
WELLS: PUBLIC: N/A FT LIMITED USE: NIA FT PRIVATE: 100' FT NON —POTABLE: N/A FT
BUILDING FOUNDATIONS:20' FT PROPERTY LINES:27' FT POTABLE WATER LINES:46' FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [✓] NO 10 YEAR!FLOODING? 1 ] YES 1,/] NO
10 YEAR FLOOD ELEVATION FOR SITE: N/A FT MSL/NGVD SITE ELEVATION: N/A FT MSL/NGVD
TEXTURE
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES: 25- Nettles:and Oldsmar
MUNSELL #/COLOR ! TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES :; 25- Nettles and Oldsmar
OBSERVED WATER TABLE: INCHES [ABOVE/BBLOW t] EXISTING GRADE. TYPE:[ PERCHED /APPARENT I
ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [.ABOVE/BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO MOTTLING: [ ] YES [ ] NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING:Sand.60 DEPTH OF 'EXCAVATION: INCHES
DRAINFIELD CONFIGURATION: [ ] TRENCH [V/] BED j ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA:
SITE EVALUATED BY: DATE:
D8 4015, 08/09 (IObsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC
Page 3 of 4
STATE OF FLORIDA APPLICATION # AP1365772
DEPARTMENT OF HEALTH PERMIT # 56-SF-1879729
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE1119028
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Jeffrey & Gina Moore
CONTRACTOR / AGENT: Gem Builders, Inc
LOT: 14 BLOCK:
SUBDIVISION: Pine -Hollow ID#:2321-802-0016-000-9
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED iPERSON. 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: 1.40 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [RESIDENCES-TABLEI / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 2100.00 GALLONS PER DAY [ 1500 GPD'/ACRE OR 2500 GPD/ACRE ]
I
UNOBSTRUCTED AREA AVAILABLE: 760.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: TBM1 IR In Cut Out, center of cul-de-sac
ELEVATION OF PROPOSED SYSTEM SITE 23.00 [ INCHES / FT ] [ / BELOW ] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: 100 'FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 100 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 25 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
SOIL PROFILE INFORMATION STTF. 1 RnTT. PROFTTM TNFORMATTON STTE 2
USDA SOIL SERIES:Wabasso sand
Munsell #/Color Texture
Depth
10YR 7/1
Sand
0 TO 9
1 OYR 5/1
Sand
9 To 39
1 OYR 611
Sand
36 To 43
1 OYR 2/1
Spodic Material
43 To 51
1 OYR 4/4
Sandy Loam
51 To 56
1 OYR 4/4
Loamy Sand
56 To 61
1 OYR 414 i
Sand
61 To 72
USDA SOIL SERIES:Wabasso sand
Munsell #/Color Texture
Depth
1 OYR 7/1
Sand
0 To 10
10YR 511
Sand
10 To 39
10YR 6/1
Sand
36 To 44
1 OYR 2/2
Sand
44 To 49
1 OYR 413
Sand
49 To 55
1 OYR 4/4
Sand
55 To 72
OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: S6 INCHES [ ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 36.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM. SIZING: Sandy Loam/0.80 DEPTH OF EXCAVATION: 51 INCHES
DRAINFIELD CONFIGURATION: [X] TRENCH [ ] BED [ ] OTHER (SPECIFY)
7 REMARKS/ADDITIONAL CRITERIA
WSWT determined using USDA WSS and soil borings.
10YR6/l stripping In 10YR6/1 matrix _%10% with diffuse boundaries starting at 36" In S61.
SB1 23" above BM. SB2 25" above BM.
SITE EVALUATED BY / t- DATE: 1O/22/2018
Ingram, Brian (Title: Env nmental Specialist II) (ENVIRONMENTAL HEALTH)
DR 4015, 08/09 (Obso,etes previous editions which ma not be used) Incorporated: 64E-6.001, FAC Page 3 of 4
AP1365772 EID1870729 v 1.0.2
r
I
STATE OF FLORIDA PERMIT NO. -Sir 19717Z9
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE. PAID:
' SYSTEM RECEIPT #:
�`OpM6 APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
Vol New System [ ] Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair [ ] Abandonment [ ] Temporary [ ]
APPLICANT : Jeffrey and Gina Moore
AGENT: EDI,C, Inc. TELEPHONE: 772-223-5200
MAILING ADDRESS: 10250 SW Village Parkway, Port St Lucie, FL 34987
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: 14 BLOCK: Unit SUBDIVISION: Pine Hollow PLATTED: 1999
PROPERTY ID #: 2321-802-0016-000-9 ZONING: AG2.5 I/M OR EQUIVALENT: [ No ]
I i
PROPERTY SIZE: 1.43 ACRES WATER SUPPLY: PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPE
IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: N/A FT
PROPERTY ADDRESS: Lot 14 Pine Needle Dr
,I TO PROPERTY: Lot 14 Pine Needle Drive ( Last lot on left an end of road)
BUILDING INFORMATION
RESIDENTIAL
[ 1 COMMERCIAT.
Unit
Type of
No. of Building
Commercial/Institutional System Design
No
Establishment
Bedrooms Area Scrft
Table 1, Chapter 64E-6, FAC
1
Singl Family
3 2181
300gpd
2
3
4
[ ] Other (Specify)
- !411
4
9 Obsoletes previous editions which may not be used)
64E-6.001, PAC
Page 1 of 4
Architectonic inc
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