HomeMy WebLinkAboutAFFIDAVIT - PERMIT -APP SEWAGE DISPOSAL - SEWAGE DATE SHEETARCHITECTS AND/OR ENGINEERS AFFIDAVIT
Southern Standard Building Code as adopted by St. Lucie
County Board of County Commissioners - Section .105.6B
SCANNED
The plans submitted for CINDY7 SPENCER `StLUCI13Y NameCounty
_5612 Spruce Drive,__Lot 1, Bl•ock 78,•Unit 9, I.R.E.
Address --
conform to the laws and to egress, type of construction
and general arrangement, and the plans and design conform
to the requirements of this Code as to strength, stresses,
strains, loads and stability.
By
Arch ect or FngineL�r'
Wayne U. Sines, Jr.
FL # 1313178
(Seal)
PERMITS ISSUED UPON AFFIDAVITS
Southern Standard Building Code - Section 106.5-
Building constructed for Wayne Construction Co.
- Name -
5612 -Spruce Drive, Lot 1, Block 78, U.9 I.R.E
Address CANNED
under Building Permit # 23906 has been St Luce County
completed and the work has been done in conformity
with the approved plans and with the structural provision
of the Code.
By
rchit t or Lngajieer,
Wayne U. Sines, Jr.
FL # 13178
(SealtA
` ,JA'
I
I
`
5L.
I
A
r I
Y!j
.
4}f
h.�
DEPARTMENT OF jEA
LT
H ACID' REHAH:
DXVIsIOM OF HEA:
e Application and.lji
4 ,? Individual ,}'Sewage 'pispom
'section I ° Instr"uct ons
1 Pekcolat,on' .test'data,.`soil
file andAMter table elevation
informatioi mustL be,;atiac4ed
(Note Test m}ist,' be made: at F
',proposed,166atiOn yOf sys tem)• ?i','iu ,q, n ;s
2 Eacsting>bvzld/ng:-,aj)d`,progased
• , •,.1
buildings. on lot .must be sown
and drawn"to scale:at'their ' Notei
locationbr" propo'sed location
' ' (Use' bloc}��ion this{ sheet or *+ ; y 2
attach RIC plan).:
Proposed locaton`o# septic
{
4. Any, pond of stieaik areas 'must ` 4
r
be indicated
on the"plan
3' ARV, .i
,
Section•II - Information.,
1 Property A3dress.dStreet & Housel,10.
'j Block. Subdivision / L�
Date Recorded (niL(a DirectopSh,td,,Job
2 Owner pr' Builder- T dwvc- � Wj. ; Or
P,0 Address-.-, Rsif$' JpRce
3 Sgecificat` ons
Tank Drainfie}a
Gals it of •6 clay wile. j+4c
or 5"`perforated,
plastic
3i'xench'or `Y.,..
Gals�ft ; of A'! clay drain
or 4N' Perforated' y
2y� trench'
4. House to b@,COn$truCted;:%%Y
Check one:,, :FHA
VA. " CCoonnventional i►•-@
'This is to certify that'rthe project' ,„
described.' this appl cat on,'and as; a
detailed by; „th'q''plans.and specifics
tionsand at'tachments`will'be,con
str .cted itacdordance' With state.
6
r
COunty Health D'eoartment
TIVE SERVICES V
eilities t ,' _ _
ate ;r'pame,and date of`
ding -of subdivision' if
ecorded,"attach +metier and
s description
�te':the Following infor
n section,.,
a`id'if,sewer is gvailable'
iduai' well must be 7$ feet
any pant of'system.,'.
and give
office a 24=hour notice
ready for inspection-,
1 J
77
—F-A3G W, (:W1 :!rJ4c.t
,r,{ q L.SCANNED
BY
saa3e '5oa St Lucie:County.`
Isar}'
"ERM1� EXPiRl;S. QrtE (1) :_. a
RONIDATC OF ISSUA�IGE � '
O
rt
r
t V016'if^well rn'septrc ' I y' �
n is installed rn 8' location :�, i m
ti�an',raa P rrs ittebi, x ,' ? O
t�HE'At:TH DCPAE2TNIENF==, , .� t!
>Ritdyl�L f2FDIRED m
R { Kti
2AlNFI�LD TO.�ErINST�IaLED ' a.
THIN THE SPF1riFn ril , r _':.'
fwyt- Gq R. V'j G. V=V ,7Vv,,✓, a
i3 (Front)
P ease Print ;(warm of Street or state Road) '
Signature
a ,pate n,
NOT'T'?tt?TE HL'T.PI�T ;CRIB LINE #.:rt # ! # * # * ! * ! r • # #
Section':IIZ, 1,icat on- Approval'.'^&'.Construction Authorization
Install " c to 11 7 t, z}g,spegial conditipna
Tte,abov signed application s'..been fqund to be in compliance with Chapter'17=13,
' Florid inistrative Cod@,`and construction is hereby approved, subject to, he
?o cation conditioi)sr`�
By' Countyrye$lth Dep Cure, pa
# # # t f # A # * W.
! 4,
"Section,IV Final .Construction A royal , „k F r 4
Construction of n igstallatioapprpved Yes'
t ,� Note::
N r
FFIA o
TEMPOPARY
9
y
IW
i4 � ^_ , F ( '+ a _, +y'�,S r ''^•� it � � q F ' ! S,'
/%
'
INDIVIDUAL SEWAGE DISPOSAL FACILITIES i
DATA SHEET /
Location: �!�/� �/Y�i'rP �k j ue Applicant: W Ate OFi L7 LtS uC�/U� �C7
County; S7l .L sir i
NOTE: This septic tank'system is not located within 60 feet of the high' water line of a lake, stream, canal or other waters,
par within 76 feet 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.
Plot plan must show
all data required per
yt1 IOD-6.03 2(a) and
All other pertinent
Z
data.
y,- �Yt11
SCANNED
la BY ..
St Lucie County
1j
C4 ' re
' - 3 t >n S- a •- - '
PLAN F
ql
i SO L DATA .�r LEGEND
p'
Drainage Pattern
.t ¢�t'���i ��,y, i e •� _proposed Sepilo Tank &
ga`
e Proposed Water supply well
;� 4 i Q Existing Water Supply Well
t x t t 5 ® Soil Boring and. Percolation'
Y Y e Test Location.
e �; Elevet�on'In relonan to crown`oP road
SOIL BORING
LOG Elevation In relation to adlacent lot
,
Soil ldentihcgtion: CLASS � GROUP
Soil Cjiaacteristics �9`s1 �tP T 'S� !!!;A
PerCOlatlOq Aate 'Tin
I'
Watei Table Dop:h
Water Table Do
Camp
cted FIII Of _ - ;
During Wet Season CERTIFIED BY
.r
Re d
Compacted Fill Chocked Byl
Dan . Lr %� da >2G N .! R 7, Date ' 1A3—b % y1
a
4 ff 1