HomeMy WebLinkAboutOWNER BUILDER AND APP SEWAGE DISPOSAL FACILITIESb
I
NOTICE: OWNER/BUILDERS
OWNER/BUILDERS OF ONE OR TWO-FAMILY UNIT DWELLINGS, OR COMMER-
CIAL BUILDINGS UNDER $25,000.00 IN VALUE, ARE EXEMPT FROM THE
REGULATIONS AS SET FORTH IN FLORIDA STATUTES 468 WHEN'BUILDING
FOR THEIR OWN USE AND OCCUPANCY ONLY. SCANNED
BY
THE SALE OR LEASE, OR OFFERING FOR SALE OR LEASE, OF SAID St Lucie County
STRUCTURE IS A CRIMINAL VIOLATION PUNISHABLE AS A MISDEMEANOR
OF THE SECOND DEGREE.
IN ADDITION,_ IF THE OWNER/BUILDER DOES SELL OR LEASE THE DWELL-
ING, HE MAY SUBJECT HIMSELF TO A CIVIL LAW SUIT.
I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE ABOVE
NOTICE ON THE DAY, OF , 1978.
\iicA2 �d
O
OWNER/BOTIDER
er m L
,t"" � tipT,r i��a � g y.�7� t a •� i v yti7,� ! � ,���, � . e
ApP icati n/Pe it
No/�% (� �. aS County health Department
DiEPARTTNTOF HEALTH'AND,REHABILITATIVE SERVICES
�DhVISION,..OF:,ION,..OF:, HEALTH•'
App'hx'cat101 baud, Permit '
u
individual' Sewage,Disposal Facilities' t•
Section I - Instructions: •. ". ,� �•
1. Percolation test data, soil pro- 5. Indicate name And date of
file and water table elevation recording of subdivision. If
information must be attached. not recorded, attach metes and,
(Note: Test must be made,at' bounds description.
proposed location of 'system). 6. .Complete the following info::-
2. Existing building and proposed;., ' mation.section.
buildings 'on ;o1: must''•be ,shown
and drawn to 'scale at,, their Notes
locatign'or proposed location 1:: Not valid lif•sewer'is available.
(Use block'on•this sheet, or , 2. .Individual well'.must be 75 feet
attach plct'plan). '° fYbm')any,par&6i'system.
3. Proposedlocation of sept1C 3" Call 461-5350 and give
tank must be shown on plan., this office a 24-hour notice
4. Any pond'or stream areas ,-must`• when ieady.'fgr inspection.
be 'indicated on the:plan:
,
Section II: Information
1. Property Address (Street "& House ',No.) Corner of Pensacola Road and Lee Bp 14, evar,d,
Lot _Block Subdivision , Lakewood' Park. Unit OA
Date Recorded 10-20 . Direction's to, Job Corner of Pensacola Road
and:Lee Boulevard'"
2. Owner or, Builder Richard Kelly
P,.O. Address 1022' Florida
3.` Specifications
Tank a Driinfield "Scale 1`.- 50'
Gals. ft. of 61' +clay, til'e
or 51' perforated (Rear)
plastic, drain' in,a'
3' trench, or:, *- I
m
Gals. Six ft. of 4Malay drain;-' .0 THIS PERMIT EXPIRES ONE (1)
or 4" per`fo,rated YEAR FROM DATE OF ISSUANCE'
plastic -drain in an "
18" trench,.
4. House to, be'constructed:• t ermrivolbit%^rgyt'creGP�Ic
Check one,: FHA ; m (n systerrI is installed'tn (ocat on
VA X Canventional ',' rt a' e$her than area i r n t d.,
:!o PRIORHCAt ft}DCAR fP,1C,vT o
APPROVAi
This is to certify that the -project N n
t
described in this-appl cation, and as ": ILD TO BE INSTALLED rt
detailed' by" the plans and specifica' "@ pRPiNFIE
bons' and attachments willr:.e con'- a Vll* I" `" r S'rtCSF}ED Fit.LEO
strutted in' accordance with' state, A.Fieh,
,requirements:.
Applirant: •Richard 'Kelly" (Name of Street."
,-
Please Print'" eet or state, Road) SCANNM�'
Signature ',Ai Date `Nfa,+rh 1q R '
Zt 7 S Lucle Count
,x� pp Np,.P, WRITE,BELOW. THIS LINE x� x + : x� x *;,x x x a x,• x x
Section IIIApplication'Approval-&,'Construction''Authorization_ •-f. ."•'
Installation subject to following special conditions:.'. ;.._
101
The ab e' signed•ap ication Ina ."been, found to,be sin, compllance' with Chapter _17 13, , ,."`,;
Floriaa(Adminis a e de, and' construction is.hereb hap roved, subject to the Of
abo =1 c-fit conditions
Hy. County °Health DVp4 bateT/ f tD
xx•*•x"xxx.'*.xxx•. xx;xx*x'x�'. xxx'.xx+
Sectio Final Construction Ap'ro�Al;' ,
,. Co ruction of installation ;approved:. Yes ` ' No' s'
Date: By.
FHA No. ?` VA;No.
TEMPORARY
SAN
REV. 7/1/73'r.'
n
ylt k ys
tA,eeta Yj 4t 1 s yl,,• f„ y #v S x Y CJF s'' fi i s -mr x F
,l e <. L nt l�iv,Y.✓+fi at s raa, hl r <y y •" x
Y 5A A 14 4 u at yd k 4 ry
$ r ' J ws�vl yt Y, t FF+Z' t t ` 'p. Pa )L*i"M,<i t Jy"tHit g:itNs tllfci S"? { I+r ri, Cif *' 4 t l 5-A.
y 4nd Hex tiA, � tl P , 5 N' \ i ;
n<P v r"'vv i1 {rys{$�,.. J' ! t��!£A t*+�.,tla r,r, t i
+...Ik f t Ed' \r,4j Y 41 'Y"+ '6R4,4gi lP xKF SI s } LY. lr tit Mof11
='uahFL'ORID"A DEfaAi2TMEIT LtLUTI01U
OF' POGONROf rti �t i
t � I
�r # vn.: h'ad d)r. e" r : >w ` t a.i ri >r 6� o-.r r, y 5t ! i
k
8 E Subregwnt.
I kin Y 1P I Y f I•, r `/� f 7 P*rd ,�. x ,i e ^ i? i tkutR.
806 South 6ih Street s. ,
' • Fort tPi&cej, Plorltla
r kr cR Tel t(305)464 t8625 "i
' Y ✓ f' a.r r�,, t > Y•py ` ' M y , !'�' 14y
UP
/ND/V/DUAL"SEWAGE
D%SPOSAL FACILMES
;DATA, SHEET
Location: Lot 5, Blk. 3 Applicant Richard Kd11v' L'
Lakewood P9rk UiAtl BA County idint Luai`�
l l...i " t ,F
NOTE.', This septic • tank syrstem is not loaoted wtlW 56teet of the 'high water line of h` lake, stream, canal or
other Wpters, nor+wifhm 76 feetj of any jpbrvafe, ell,tnor within 100jeet 'of an Dublic •water supply" G,
` tlwafes iubal.,� v otof$ '�ifhtn `10 fe` ot,ony_„publics�e_wer system.,,
—13aL_JeJ1b et
It
�
F
4
�-
q
M1 /rK
' {{
zt
M .• Plot pon
. Must show
data
required to
IOD;-6,,03
'2(a�)
.and
all other
pertinent ;;,,
i
Alto.
sy''I
S
4466
b E
It edyr y�
rib
3
MOr 4Aij
tVtYJ
tj Y� 4 i
'•
Ilk ayi
'
y /y
i � /R
h•4{/
'[f
's
LEGS ND
°7 `i
r
:,I
r1t
0..
. � .a
.t C
v
i f9 6� I "t f J y r YK r i , i;•
sir � m5 �x" Iprl� d sse J sa g ,.
Ott
rJ
l 4Y tf K` i i 'o
u1
y�'t'ik�"•�-,�t LDO��, Rs tiwl .$fr,i. C e'4.V � I �1+��44'"'�.�, r [ `+�
e" SoFI'°Iden4tfkoatlat!' GLRSSf a GROUPI; {
*ISoitaChoraetarioicp``P Io7..� �5--ands-r—rk ` �:r
r�Cailnn $'�� S�' �d .✓�4' t� <i�.: es� d,j.5v
Percolation Rate min/inch
1
Water Table Depth D Y 75 '"� '� tI' S �*� a s r
It,�� � Y GERTIF
► Drainage Pattern A
Propo§ed Septw7onk and'✓ \ ,.,�.^?•,
DrairtfPeld tl
®Pmpoed Water Su11 pply Viell
(�caisfing Go', SuWell
t _ u,"'T;
y'k
tt"r 5; k5r "•, � ;. �.
$h0st ' �" 0