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Home My WebLink AboutD O H PAPERWORKa STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TRE]MMENm AND SYSTEM 1 RECEIVE® APi POSAANO V 0 9 2018 ST. Lucy County, Permittinc PERMIT #: 66-SF-I 878629 �TION #:AP1365113 TE PAID: FEE PAID: ECEIPT #: CUMENT #: PR1164260 CONSTRUCTION PERMIT FOR: OSTDS Existing M cation APPLICANT: , G c>— PROPERTY ADDRESS.: 49M Deanna Ln Fort Pierce, FL 34946 LOT: 2 BLOCK: 3 SUBDIVISION: Green Acres PROPERTYIID #: 1430-702-0018-000-8 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX,ID NUMBER] SYSTEM MAST BE CONSTRUCTED nd 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 PEN ET BEING MADE NULL AND VOID. ISSUANCE I OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR, LOCAL P x-=xNG REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. I SYSTEM DESIGN AND SPECIFICATIONS T I 900 ] GALLONS / GPD Sentic New CAPACITY A [ I ] GALLONS / GPD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY Sn;= TANK:1250 GALLONS] K I I 1 GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps I ] D [ 334 ] SQUARE FEET Drainfleld New SYSTEM R [ I ] SQUARE FEET NW SYSTEM A TYPE SYSTEM: [ ] STANDARD [x] FILLED [] MOUND [ ] I CONFIGURATION: [ I TRENCH [x1 BED I ] N F LOCATION OF BENCHMARK: Orange paint mark on crown of road I ELEVATION OF PROPOSED SYSTEM SITE [ 5.00 1 n7CHES FT 1 [BELOW IBENCH ARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 1.00 1 nNCHES FT 1 1� BELOW ]BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [14.001 INCHES EXCAVATION REQUIRED: ] INCHES The system is sized for 2 bedrooms with a maxunurn occupancy of 4 persons (2 per bedroom), for a total estimated flow of 0 200 gpd j H i E R SPECIFICATIONS BY: Jason Harr/ids _ TITLE: Septic Tank Contractor APPROVED BY: TITLE: Environmental Supervisor I St. Lucie CHD Dianna S May ff DATE IS'';EI : 09/20/2018 EXPIRATION DATE: 03/20/2020 DR 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT :ATION FOR: PERMIT NO. 56o"Sr— I I-M2q DATE PAID: FEE PAID: RECEIPT #: GAG. New System f Existing System ( ; Holding Tank Ly'j. Innovative JJF Repair .1 t Abandonment I Temporary ( ii ,� j. C cl:.¢.c, (: ; '✓ APPLICANT: /� (� ,� (( ,c, ��LiL� AG I NT:Avi 'f IJ_ ! r TELEPHONE: 4A LING ADDRESS U IF_ � )0* -Iriy e b(L. is cI ri TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MOST BE CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489.105(3)(m) OR 469.SS2, 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 GRANDFATRER PROVISIONS. PROPERTY INFORMATION a LOT—�_ BLOCK: SUBDIVISION: CO"^e(ri C PLATTED: & PROPERTY ID #: )�?Q --%'9 I/M OR EQUIVALENT: Y PRO ERTY SIZE: fi•% �7 WATER SUPPLY: i j PRIVATE PUBLIC t9\,j<=2000GPD I 1>2000GPD IS iEWEA AVAILABLE AS PER 381.0065, FS? Y DISTANCE TO SEWER: FT PROPERTY ADDRESS: CL -: 4c gg 4 � (1 j DIRECTIONS TO PROPERTY: �i, itl`� 1 2� 31 4 DR MG INFORMATION Type of Establishment it1 sii sent RESIDENTIAL I ( COMMERCIAL No. of Building Commercial/Institutional System Design Bedrooms Area Sit Table 1Table 1.Chapter 64E-6.FAC64E-6, PAC Lac, �Ob Floor/Z%ipment Drains j Other (Specify) URE: f DATE: .._lie S, 08/09 (Obsoletes previous editions which may not be used) orated 64E-6.001, PAC Page 1 of 4 LOT: STATE OF FLORIDA DEPARDEW OF BEALTH ONSITE SEWAGE TREAMlENT AND DISPOSAL SYSTEM EXISTING SYSTEM AND SYSTEM REPAIR EVALUATION PERMIT # bG-SF-197&29 BLOCK: ''� SUBDIV: %%�? 'Z I'1'1)/� ID#: F jSO. 70-2••c' c, TO BE COMPLETED BY FLORIDA REGISTERED ENGINEER, DEPARTMENT EMPLOYEE, SEPTIC TANK CONTRACTOR OR OTHER CERTIFIED PERSON. SIGN AND SEAL ALL SUBMITTED DOCUMENTS. COMPLETE ALL APPLICABLE ITEMS. COMPLETE TANK CERTIFICATION BELOW OR NOTE IN itE MUGS WHY THE TANKS CANNOT ,BE CERTIFIED. EXISTING TANK INFORMATION [ GO ] GALLONS SEPTIC TANK/GPD ATU LEGEND: MATERIAL: Cr.^t f-'r1 BAFFLED: [YQ N61, [ ] GALLONS SEPTIC TANK/GPD ATU LEGEND: MATERIAL: BAFFLED:(Y[j No [ ] GALLONS GREASE INTERCEPTOR LEGEND: MATERIAL: [ ] GALLONS DOSING TANK- LEGEND: MATERIAL: # PUMPS:[ ] I CERTIiY THAT THE LISTED TANKS WERE PUMPED ON �I/ BY �f A1 44 HAVE THE VOLUMES SPECIFIED AS DETERMINED BY [ DIMENSION t L"rr TNA / r.vapun - i _ �Qr MMMWA, AND HAV5 A [ SOLIDS DEFLSC ION DEVjICl2 % r, ; OV LICENSED CONTRACTOR BUSINESS NAM£ iL a . DATt EXISTING DRAINFIELD INFORMATION ------ — �_ [ y o ] SQUARE FEET PRIMARY DRAnwIELD SYSTEM NO. OF TRENCHES I ] DIMENSIONS: X �U [ ] SQUARE FEET SYSTEM NO. OF TRENCHES [ ] DIMENSIONS: X TYPE OFISYSTEM: Imo; STANDARD j r FILLED ) HOUND j I CONFIGURATION: j TRENCH I BED DESIGN:I ( i READER I D-BOX \ GRAVITY SYSTEM I j DOSED SYSTEM ELEVATIi OF BOTTOM OF DRAINFISLp Its RFSATiON TO EXISTING GRADE _Z%jftNCHES [ ABOVE CBEL�fflSYSTEMFAILURE AMID REPAIR INFORMATION [ fC\9 ] SYSTEM INSTALLATION DATE TYPE OF WASTE '1 1 DOMESTIC I l COMMERCIAL GPD ESTIMATED SEWAGE FLOW BASED ON (METERED WATER ITABLE 1, 69E-6, FAC SITE I j DRAINAGE STRUCTURES I POOL I I PATIO I DECK j PARKING CONDITIONS: I 1 SLOPING PROPERTY I NATURE OF FAILURE: I I HYDRAULIC OVERLOAD I SOILS j j MAINTENANCE I ti( SYSTEM DAMAGE I I DRAINAGE / RUN OFF I ROOTS 1 I WATER TABLE I FAILURE J I SEWAGE ON GROUND IQC TANK IAl D BOX/HEADER I e-l\ DRAINFIELD SYMPTOM: I I PLUMBING BACKUP I REMARKS/ADDITIONAL CRITERIA �c,►1�'{5CLa:k SUBMITTED BY•T_ TITLE/LICENSEL C,()NI, �li�� DATE:- �n DR 40Z5, �08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC Page 4 of 4 , 5 � 1 STATE OF FLORIDA PERMIT #. 56"sF-187�Gti9 DEPARTMENT OF HEALTH ! /gs ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS APPLICANT: __ LOT: I BLOCK: SUBDIVISION: i•"�i (r6_'f' '.5' [Section/Township/Parce2._No. Or Tax ID Number] TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINEERS MUST 1PROVIDE. REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SnAMrrmnr. rnMe�.srmr rr, PROPERTY SIZE CONFORMS TO SITE PLAN: ,[� YES j aj NO NET USABLE AREA AVAILABLE: i / ACRES TOTAL! ESTIMATED SEWAGE FLOW: 7 '•� GALLONS PER DAY : r__ SID __C _ AUTHORIZED SEWAGE FLOW: RESIDENCES-TABLE2J (;- GALLONS PER DAY l:50lD__M%ACRE OiF— 98 GPD/ACRE] UNOBSTRUCTED AREA AVAILABLE: ;1:! SQFT UNOBSTRUCTED AREA REQUIRED:_ 'l T SQFT BENCHMARK/REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE IS pc�BEL _ ] BENCHMAE[K/REFERENCE POINT i THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: ;�s':� FT DITCHES/SWALES: �J!J FT NORMALLY WET? [ j YES [T] NO WELLS PUBLIC: ,V FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: 1'+};'t tj FT BUILDING FOUNDATIONS: ; FT PROPERTY LINES:a FT POTABLE WATER LINES: ILA FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [;q NO 10 YEAR FLOODING? [ ] YES t<j NO 10 YEAR FLOOD ELEVATION FOR SITE: i'.,3'}• FT MSL/NGVD SITE ELEVATION I. . •P$ FT MSL/NGVD i SOIL PROFILE TNrnRPAAapTnwu e•r.ez. DEPTH r: r'-r•f I l:.��: stir_:_. �4`-••_ 1 USDA I SOIL SERIES: _ ; c� :• ii .; - i� TO I SDA SOIL SERIES: OBSERVED WATER TABLE:CC`( INCHES ABOVE /BELOW]' EXISTING GRAfl�E. T7[PL�:,CPERCI3FD /APPARENT[ ESTIMATED WET SEASON WATER TABLE ELEVATION: nrcHES HIGH WAi R TABLE VEGETATION: I ] YES V'.] NO MOTTLING DOVE BELOW) "EXISTING GRADE `` 6-`F1,YES [ ] NO DEPTH: INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING:'C`� B �l, DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: [ I TRENCH BSD INCHES CtF.MARKS%ADDITIONAL T/ C ] OTHER (SPECIFY) !`. _ •.i1 %•�., (\ CRITERIA: 1�1`.1Yt:�. i•`.. 1!ll:: SITE EVALUATED BY: DH 4015, O8/09 (Obsoletes previous editions which may not be used) Incorpamted: 64E-6.m. FAC , � Page 3 of 4 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT . CONSTRUCTION PERMIT FOR: APPLICANT: Carlos Robaina OSTDS Existing Modification PROPERTY ADDRESS: 4938 Deanna Ln Fort Pierce, FL 34946 LOT: 2 BLOCK: 3 SUBDIVISION: Green Acres l PERMIT #:56-SF-1878629 APPLICATION #: AP1365113 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1154260 PROPERTY ID #: 1430-702-0018-000-8 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] i 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 I 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 [ 9010 ] 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 [ 334 ] 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: Orange paint mark on crown of road I ELEVATION OF PROPOSED SYSTEM SITE [ 5.00 ][ INCHES FT ][ ABOVE BELOW] BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 1.00 ][ INCHES FT ][ ABOVE BELOW] BENCHMARK/REFERENCE POINT L D FILL REQL O The syst T 200 gpd. H E R Ll4.UUJ INCHES EXCAVATION REQUIRED: L J INCHES is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of SPECIFICATIONS BY: Jason Harris TITLE: Septic Tank Contractor Supervisor I I Environmental Su APPROVED BY: �4i..r-�-•�— /fl�tij� TITLE: P Dianna S May 101 DATE ISSUED: 09/20/2018 EXPIRATION DATE St. Lucie CHD 03/20/2020 DH 4016,108/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 v 1.1.4 AP1365113 SE1104196