HomeMy WebLinkAboutAPP SEWAGE DISPOSAL - OWNER BUILDER - PERMITI
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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.
THE SALE OR LEASE, OR OFFERING FOR SALE OR LEASE, OF SAID
STRUCTURE IS A CRIMINAL VIOLATION PUNISHABLE, AS A MISDEMEANOR
OF THH SECOND DEGREE.
.'IN ADDITION,_ IF THE OWNER/BUILDER DOES SELL OR LEASE THE DWELL -
SCANNED
ING, HE MAY SUBJECT HIMSELF TO A CIVIL LAW SUIT'. BY
St Lucie County
I HERIHBY ACKNO.WLED E THAT I HAVE READ AND UNDERSTAND THE ABOVE
NOTICi ON THE DAY OF qJ^G , 1978.
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J
7y County -Health Denartment
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
DIVISION'OF HEALTH
Application and Permit
of
Individual Sewage
Disposal Facilities
n I - Instruction's:
rcolation -test data, 'soil pro- •.
5.
Indicate name and date-gf—
le and water table elevation
recording of subdivision. If
formation must be attached.
not recorded, attach metes and
ote: ;Test}''must be made at
bounds description.
oposed location of -system).
6.
Complete the following infor-
isting building and proposed
mation section.'
ildings on lot must be shown
'
d.drawn to scale at their
Notes:
cation\or proposed location.
1.,
Not valid if sewer is available.
se block"on this sheet•or'
2.
Individual well must be 75 feet
tach plot plan).
from any part of system.
oposed location of septic
3.
Call 461-5350' and give
nk must be shown on plan.
this office a 24-hour notice
v pond'or stream areas must
when ready for inspection.
indicated on the plan.
n II - Information: -'•
I
1. Property Address (Street & House No.) Jeffrey Lane
Lot 10 Block subdivision. Cardinal Glenn
t,. Date Recorded Jobs t tio Dir
ecno Fast. nri
A!Pec a: Drive 4 7
East on Jeffrey Lane )i7;)ft- Wit". nn rivkzt
Owner or Builder andall Walker
r P.o. Address �qq riff P� r Fort 'Pierce, Florida ,-
,3. S ecifications
Tank Drainfield Scale' `" 50' SCANNED
Gals. ft-. of 6" clay ,tile BY
or 5" perforated .S't I .i irio f'OUilt�
plastic drain in a
Z(� /�, 3' trench or', z
[ Gals. ft. of'4" clay drain W
or 4" perforated m
/plastic drain in an'. M1
trench N`
4. House to be coristructe'd- rt
qheck one: •, FHA , m m
m P.
VA X Conventional rt �
This' `j`jis to` certify that,'the project, a
described in,this'application," and as rt
deta led•by,the plans and specifica- m
tion�I and -attachments will be cqn- a
strugted in accordance':with•state
^re6uirements.
Appl
:A In
Sign
Sect
cant- Randall Walker _ (Front)
'Please Print (Name of Street or State Road)
F a r r
tune: V _ 'Date: March 7, 108 i
*1 * * * '* * * * * * *DO NOT WRITE° HELOW THIS LINE * * * * * * * *`*'*
on III L% lication Approval&_Construction Authorization ./!
tal�lat'ons 3e t to p3llo ng pecial conditions: �it..4�iHc.�-e�0
BY:
Section IV -.
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zlyu1.e-1 / b U-0-ry�. Jc.c... Lv� 4!—
ned application has been found to be in compliance with Chapter 17-13,
istrative"Code and construction is hereby approved, subject to the
cations an4lconditions.. r/
�/1_�" 4i County Health Dept. ���Ge.2 Date-3/-2 7�
1 Construction Approval
Construction of installation approved:
Yes No
Date: By:
-
FHA No. VA No.,14
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TEMEORARY
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