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Home My WebLink AboutD O H PAPERWORKSTATE OF FLORIDA ONSITDEPE�SEWAGE TNT OF R D� P 6 SYSTEM )NSTRUCTION PERMIT FOR: OS PPLICANT: Dwiaht Mike Goodner ADDRESS: 5025 Emerson Ave Fort Pierce. FL 34951 LOT: I PROPERTY ID #: BLOCK: SUBDIVISION: DEC m 5 4018 PERMIT #:56-SF-1876081 APPLICATION #:AP1363503 Lucie County, Permitting DATE PAID: FEE PAID: #: PR1166754 1315-113-0001-010-7 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] I SYSTEM I 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 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 [ 900 ] GALLONS / GPD Septic new CAPACITY A I ] GALLONS / GPD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] X [ ] GALLONS DOSING TAME, CAPACITY [ ]GALLONS @[ ]DOSES PER, 24 RRS -#Pumps D [ 250 ] SQUARE FEET Drainfield new SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [X] FILLED [ ] MOUND [ ] I CONFIGURATION: [X] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: site BM yellow capped IR E of system I ELEVATION OF PROPOSED SYSTEM SITE [ 1.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 2.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L a 0 T H E R .I 1WuIHV: rII.UUJ INCHES EXCAVATION REQUIRED: [ J INURES e system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of 0 gpd. ie licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with 64E-6.013(3)(f), FAC. SPECIFICATIONS BY: Brian J Ingr TITLE: Environmental Specialist II APPROVED BY: ITLE: Environmental Specialist II St. Lucie CHI Brian J Ingr DATE ISSUED: 10/10/2018 EXPIRATION DATE: 04/10/2020 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 v 1.1.4 AP1363503 SE1116667 NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an strative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such Sings are governed by Rule 28-106, Florida Administrative Code. A petition for >trative hearing must be in writing and must be received by the Agency Clerk for the nent, within twenty-one (21) days from the receipt of this order. The address of the Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency facsimile number is 850-413-8743. Mediation is not available as an alternative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will ite a waiver of your right to an administrative hearing, and this order shall become a 'final Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. )v AF K load HEALTH PAYING ON: RECEIVED FROM PAYMENT FORM: MAIL 128 St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 PERMIT#:56-SF-1876081 BILL DOC#:56-BID-3961272 CONSTRUCTION APPLICATION #: AP1363503 Laventure & Associates Inc AMOUNT PAID: $ 515.00 CHECK 1131 PAYMENT DATE: 09/10/2018 Dwight Mike Goodner NAME: 'Y LOCATION: 5 Emerson Ave Pierce, FL 34951 Block: IrID: 1315-113-0001-010-7 EXPLANATION or DESCRIPTION: QUANTITY FEE Construction System Inspection Research Fee 1 $ -1 - Surcharge (All) -1 - OSTDS New Permit Surcharge -1 - OSTDS Construction Application and Plan Review,New 123 - OSTDS Construction Site Evaluation 126 - OSTDS Construction Permit (New or Mod, Amendment) 127 - O;STDS Construction System Inspection 133 - O;STDS Construction Reinspection I I RECEIVED BY: VanceMH I I 5.00 1 $ 15.00 1 $ 100.00 1 $ 100.00 1 $ 115.00 1 $ 55.00 1 $ 75.00 1 $ 50.00 AUDIT CONTROL NO. 56-PID-3708096 q STATE OF FLORIDA DEPARTMENT OF HEALTH �+ ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT I APPLICATION FOR: PERMIT NO. DATE PAID: rj/b FEE PAID: (10 Oi RECEIPT #: [.]1 New System ` [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT: D&,)16#7- 77�),- AGENT: c-ft(/�y�fTf1 ��l'�/ yl. /}�lG. TELEPHONE: 3�fl-y -?c) MAILING ADDRESS: FDon/Jr{LtiT� D ir» f'/£�-G� 6L TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE CONSTRUCTED BY AiPERSON LICENSED PURSUANT TO 489.105(3)(m) OR 489.552, 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 GRANDFATHER PROVISIONS. PROPERTY INFORMATION C-�c�1S LG BLGeK.. SUBDI-V*S39N. PLATTED: 0 /] PROPERTY ID #: _t//5-//,j'CL%Y�1� O(C�� ZONING: gjCl I/M OR EQUIVALENT: [ Y / N ] i PROPERTY SIZE: y 0 ACRES WATER SUPPLY: [X] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS?E Y ^/� N j� DISTANCE TO SEWER: g ICJ FT PROPERTY ADDRESS: jQZj L27*2i0 y(/1125 DIRECTIONS TO PROPERTY: C) /dU # /'700 �i /Y1//,c: /�,l INFORMATION Unit iType of No (Establishment [ j('] RESIDENTIAL [ ] COMMERCIAL No. of Building Commercial/Institutional System Design Bedrooms Area Sgft Table 1, Chapter 64E-6, FAC 1 2. 3 4 [ ] Floor/Equipment Drains o SIGNATURE: /zteti�p DH 4015, 08/09 (Obsoletes pro Incorporated 64E-6.001, FAC [ Other (Specify) !�7 DATE: < G' ous editions which may not be used) Page 1 of 4 STATE OF FLORIDA APPLICATION # AP1363503 DEPARTMENT OF HEALTH PERMIT # 56-SF-1876081 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1116667 APPLICANT: Dwight Mike Goodner CONTRACTOR / AGENT: Laventure & Associates Inc LOT: BLOCK: SUBDIVISION: ID#:1315-113-0001-010-7 TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 4,10 ACRES TOTAL ESTIMATED SEWAGE FLOW: 200 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 6150.00 GALLONS PER DAY ( 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 2000.00 SQFT UNOBSTRUCTED AREA REQUIRED: 375.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: site BM yellow Capped IR E of system ELEVATION OF PROPOSED SYSTEM SITE 1.00 [ INCHES / FT ] j ABOVE / BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 100 FT NON -POTABLE: FT BUILDING iFOUNDATIONS: rj FT PROPERTY LINES: 20 FT POTABLE WATER LINES: 75 FT SITE SUBJECT TO FREQUENT FLOODING? I ]YES EX ]NO 10 YEAR FLOODING? [ ]YES [X]NO] 10 YEAR FLOOD ELEVATION FOR SITE: FT I MSL / NGVD ] SITE ELEVATION: FT I MSL / NGVD SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES:Pepper sand Munsell #/Color Texture Depth IOYR 3/1 Sand 0 To 13 1 OYR 4/1 Sand 13 To 19 10YR 5/1 Sand 19 To 31 10YR 6/1 Sand 25 To 31 1 OYR 3/2 Loamy Sand 31 To 36 10YR 4/3 j Loamy Sand 36 To 40 1 OYR 6/3 Loamy Sand 40 To 59 10YR 6/1 i Sand 59 To 72 USDA SOIL SERIES:Pepper Munsell #/Color sand Texture Depth 1 OYR 3/2 Sand 0 To 12 1 OYR 4/1 Sand 12 To 20 1 OYR 5/1 Sand 20 To 35 10YR 611 Sand 25 To 35 1 OYR 3/3 Loamy Sand 35 To 42 IOYR 413 Loamy Sand 42 To 47 1 OYR 6/2 Loamy Sand 47 To 57 10YR 6/1 Sand 57 To 72 OBSERVED WATER TABLE: 62.00 INCHES [ ABOVE / HELOW ] EXISTING GRADE TYPE: IPERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 25 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES Ex ]NO MOTTLING: [X]YES [ ]NO DEPTH: 25.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: (X ] TRENCH [ ] BED [ ] OTHER (SPECIFY) r REMARKS/ADDITIONAL CRITERIA iWSWT determined using USDA WSS and soil borings. 10YR6/1 stripping in 10YR511 matrix > 10% with diffuse boundaries starting at 25" in SB1 and SB2. SBt 1" above BM. S132 1" below PM. RP nail in tree N of.yystem, 40" above SM1 SITE EVALUATED BY: INCHES DATE: 09/17/2018 i Ingram, Brian (Tiu?/Invlronmental Specialist II) (ENVIRONMENTAL HEALTH) DH 4015, 08'/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 AP1363603 EID1876081 v 1.0.2 s STATE OF FLORIDA PERMIT #. DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS �fT� A �r APPLICANT: �R066/# LLlf E (7y'Wr�' ptA,AGENT: ��/j-� i{y7jCrlA%',t9r � LGT- is / ` lel�oy_ �7 fC'i117Y S� Ail-I-91-ON- PROPERTY ID #:, �CK3'%s 1/3--�(%/—o/o7H' [Section/Townsh' Parcel No--'gr Tax ID Number] TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [✓] GNYES [ ] NO NET USABLE AREA AVAILABLE: a/r/ ACRES TOTAL ESTIMATED SEWAGE FLOW: 2Co GALLONS PER DAY [RESIDENCES -TABLE 1/OTHER-TABLE21 AUTHORIZED SEWAGE FLOW: 677L9GALLONS PER DAY [1500 GPD/ACRE OR 2500 GPD/ACRE] UNOBSTRUCTED AREA AVAILABLE: %id, 000 4. SOFT UNOBSTRUCTED AREA REQUIRED: 3JL, SOFT 'T BENCHMARK/REFERENCE POINT LOCATION: LGQ S%fJ/'' !!it'S )�E5067kjCz:- ELEVATION OF PROPOSED SYSTEM SITE IS / _ INCHES T ABOVE/�ELOW BENC�MARi�t%H � REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: 15- FT DITCHES/SWALES: /S FT NORMALLY WET? [ ] YES D< NO WELLS: PUBLIC:' Z&O FT LIMITED USE: JC>0 FT PRIVATE: 7,5' FT NON -POTABLE: SO FT BUILDING FOUNDATIONS: % FT PROPERTY LINES:__// FT' POTABLE WATER LINES: >-/o FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES W NO 10 YEAR FLOODING? [ ] YES [ ] NO '10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD MUNSELL #/COLOR TEXTURE DEPTH TO TO TO TO TO TO TO TO TO USDA'SOIL SERIES: USDA SOIL SERIES: TEXTURE DEPTH TO mn TO TO mn 1V TO OBSERVED WATER TABLE: INCHES [ABOVE / BELOW] EXISTING GRADE. TY$E:[PERCHED / APPARENT] ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [ABOVE / BELOW] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO MOTTLING: [ ] YES [ ] NO DEPTH: INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [ ] BED [ ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA: SITE EVALUATED BY: ('-1C44AR0 4-21. 9VCyyrteE roe g-0A P L'S. 52G7 DE 4015, 0e/09 (Obsoletes previous editions which may not be used) Incorporated: 64E•6.001, FAC Page 3 of 4 d�la-one APPLICATION ():,4P1363503 STATE OF FLORIDA PERMIT P:56-SF-1876081 DEPARTMENT OF HEALTH DOCUMENT u:F11282707 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:04/1212019 FEE PAID:25•00 RECEIPT a:56-PID-3901192 APPLICANT: Dwight Mike Goodner AGENT: 'Richard Lavenlure (Laventure & Associates Inc) PROPERTY ADDRESS: 5025 Emerson Ave FortPierce, FL 34951 LOT: SUBDIVISION: BLOCK: ID#: 1315.113.0001.010.7 CHECKED [X1 ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION SETBACKS [ ] [011 TANK SIZE [11 900.00 - [21 [ 1 [271 SURFACE WATER FT [ 1 [021 TANK MATERIAL Polypropylene [ 1 [281 DITCHES FT [ ] [031 OUTLET DEVICE [ ] 1291 PRIVATE WELLS 100 FT _ [ 1 [041 MULTI -CHAMBERED [ Y N ] [ 1 (301 PUBLIC WELLS FT [ 1 [051 OUTLET FILTER POlylok PL-68 [ 1 [311 IRRIGATION WELLS 87 FT [ 1 [061 LEGEND 1. 70-156-90D-C3 2. [ 1 [321 POTABLE WATER FT [ ] [071 WATERTIGHT [ 1 [331 BUILDING FOUNDATIONS 9 FT [ I [081 LEVEL [ 1 [341 PROPERTY LINES 45 FT [ ) [091 DEPTH TO LID [ 1 [351 OTHER FT DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM [ ] [101 AREA [1] 255 [21 SQFT [ 1 [361 DRAINFIELD COVER [ 1 [111 DISTRIBUTION BOX _ HEADER X [ 1 [371 SHOULDERS [ ) 1121 NUMBER OF DRAINLINES 1. 4.00 2. [ 1 [381 SLOPES [ I [131 DRAINLINE SEPARATION [ ] [39] STABILIZATION 07/01/2019 [ ] (141 DRAINLINE SLOPE [ 1 [151 DEPTH OF COVER ADDITIONAL INFORMATION [ 1 [161 ELEVATION [ ABOVE / BELOW IBM 2.00 [ 1 [401 UNOBSTRUCTED AREA [ 1 [171 SYSTEM LOCATION [ ] [413 STORMWATER RUNOFF [ ] [18] DOSING PUMPS [ 1 [421 ALARMS [ ] [191 AGGREGATE SIZE [ 1 [431 MAINTENANCE AGREEMENT [ 1 [201 AGGREGATE EXCESSIVE FINES [ 1 [441 BUILDING AREA [ ] 1211 AGGREGATE DEPTH [ 1 [451 LOCATION CONFORMS WITH SITE PLAN FILL / EXCAVATION MATERIAL [ 1 (461 FINAL SITE GRADING [ ] [221 FILL AMOUNT [ ] [471 CONTRACTOR RONALD E MEEKS(0000245 [ 1 [231 FILL TEXTURE [ ] [481 OTHER INFILTRATOR ARC 24 [ 1 [241 EXCAVATION DEPTH ABANDONMENT [ 1 [251 AREA REPLACED [ ] [491 TANK PUMPED [ ] i (261 REPLACEMENT MATERIAL [ 1 [501 TANK CRUSHED 6 FILLED Comments: Comments are on page 2. Jl7�. r or,St. Lode CHD DATE: 04129/2019 CONSTRUCTION ( APPROVED DISAPPROVED 1' Environmental Speciatlp(fsst1]8rian J Ingram (ENVIRONMENTAL HEALTH) FINAL SYSTEM [ APpROVED / DISAPPROVED ]: \A �7. A St. Lucie CHD DATE: 07/01/2019 Environmental. 1 HunterA Collier r (Florida Department of Hea {Szplanation of Violations on following page) DH 4016, 06/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 2 of 3 EH Database v 1AA AP1363503 EID1876081 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL Comment comments APPLICATION #:AP1363503 PERMIT #:56-SF-1876081 DOCUMENT #:FI1282707 DATE PAID:04/12/2019 FEE PAID:25.00 RECEIPT #:56-PID-3901192 The system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of 200 gpd. New ST, filler, and 4x4+1 x5 long trench DF installed. No violations, system ok to cover. Contractor notified onsite. Final inspection lapproved for mound system and final site grading. Well inspected at construction inspection. OH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, PAC Page 2 of 3 EH Database v 1.0.1 AP1363503 EID1876081