HomeMy WebLinkAboutD O H SEWAGE DATA SHEET - D O H APP SEWAGE DISPOSAL�I .1`•(' ',4LORIDA DES6101 MENi OF POLLUTION CONTROL
r,.; ,
S. E. Subregion
806 .South- 6th Street
Fort Pierce, Florida 33450
Tel. (305) 464-8525
INDWIDUAL SEWAGE DISPOSAL FACIL/T/ES
DATA SHEET
Location: Lots 12, 13, 14 & 15 Applicant: Herman Porter
Block 56, San Lucie Plaza County: St. Lucie
NOTE: This septic tank system is not located within 56feet of the high water line of a lake, stream, coral or
other waters, nor within 75feet of any private well; nor within 100 feet of any public water supply;
nor within 10 feet of water supply pipes,, nor within 100 feet of any public sewer system.
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PLAN
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SOIL DAM
PIS.
must show
ail data :required
in
IOD-6.03'
'2(a)'and
all other
pertinent
data.
4"
d
SCANNED
BY
St Lucie County
LEGEND
Drainage Pattern
Savo Proposed Septic Tank and
—
� Drainfield ,
N"G- — ., ®Proposed Water Supply -Well
�'3 (3j�ri.,�'Brela..i On.,Bv�ee�nei QExisting Wafer Supply Well
SpoilBoring and Percolation
Test Location-
° 5 ---s'31 �rao.l Oaganla'nd '-
F
SOIL BORING,
LOG
I Soil Identification: CLASS GROUP•.SP ,
Sou Characteristics Poorlygraded'sands,
little or no fines ,
Percolation Rote )i min/inch "
Water Table Depth 54
CERTIFIED BY.: � _
Water Table Depth -
During
During Wet Saaeon_ &C) FLORIDA PROFESSIO L No. 221 {Q L S.)
Compacted, Fill, Of, O" Regtd Date 4-4-77 Job No, 77-300-54
Compacted Fill Checked By:
Date Sheet ,of
'F-M Tau It Flea Ring, Ilc., Ft. I•iffM Fla.
Apple it
No ��� 'vL-Q County Health Department
t
DEPARTMENT" OF HEALTH AND REHABILITATIVE SERVICES
,DIVISION OF ••HEALTH
.: ,
Application and Per�mit
of
Individual Sewage Disposal Facilities
Section I -Instructions:
1. Percolation test data, soil pro-
file and water table elevation,
information must be attached.
(Note: Test must be made at
proposed location of system).
2. Existing building and proposed
buildings on lot must be shown
and drawn to scale at their
location or proposed location.
(Use block on this sheet or
attach plot plan).
3. Proposed location of septic
tank must be shown on plan.
4. Any, pond or stream areas must
be indicated,on the plan.
Section II - Information:
5. Indicate name and date of
recording of subdivision. If
not recorded, attach metes and
bounds description. -
6. Complete the following infor-
mation section.
Notes:
1. Not valid
'2. Individua.
.from 'any, j
3 Call pA
thisrInffi5
f-sewer is available.
well must be 75 feet
rt_of system.
-5350 and give
=a 24-hour notice,
for inspection.
1. Probst Ad��e,� (Street & House No.) Iroquois Avenue
Lot ' 3' "io 56 Subdivision �Lucle aza
Date Recorded `,'1 f-2-2 Directions to Job East on St. Lucie Boulevard,
North on Iroquois 0 feet, lot on ieft
2. Owner or Builder Herman Porter
P.O. Address Rt.1,'Box 10 City_
3. Specifications
Tank Drainfield
,Gals. ft. of 6" clay tile
or 5" perforated
plastic drain in a
3' .trench or
/,260Gals, s� ft. of 4n clay drain
/or 4" perforated
P//plastic drain in an
--er trench
4, douse to be constructed:
Check one: / FHA
VA . X Conventional
This is to certify that the project
described in this application,,and as" -
detailed by the plans',andtespecifica-
t ions and attachments will be con-
structed in accordance with state
requirements.
Applicant: Herman Porter
Please Print
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IN
Scale 1" 50'
(Rear)
SCANNED
BY �4,
St Lucie Coun�j �
Pq 0
(Name of Street or State Road)
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Signature: Date: April 4, 1977
* * * * * * * * * * * * * DO NOT WRITE BELOW THIS LINE
Section III - Application Approval & construction Authorization ,
r Ids - 11 do subject to following special conditions:
The above si ed appli ion has been found to be in compliance with Chapter 17-13,
Florida istrative Code, and construction is hereby proved, subject to the
G2 G
,�'�• above o and co 'tions.
By: County Health Dept.
Section IV _ Fin Construction'Approval
Construction of installation approved: Yes- No
`Date: _ By:
FHA No, VA No.
TEMPORARY
SAN 428 -
FA
REV. 7/1/73
F 2W Taw S fro FnntiN, Inc., Ft. FI"ca, Fla.
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