HomeMy WebLinkAboutD O H PAPERWORKSTATE OF FLORIDA `
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
PERMIT #:56-SF-1953018
APPLICATION #:AP1416485
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1240691
CONSTRUCTION' PERMIT FOR: OSTDS New SCANNED
APPLICANT: (Port St. Lucie Properties Inc) RY
PROPERTY ADDRESS: 5713 Seagrape Dr Fort Pierce, FL 34982 _ St Lucie County
LOT: 34 BLOCK: 21 SUBDIVISION: Indian River Estates
PROPERTY ID #: ' 3402-609-0027-000-7 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM 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 iSERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE TEE 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,IOR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [
900 ]
GALLONS / GPD Seotic New
CAPACITY
A [
]
GALLONS / GPD N/A
CAPACITY
N [
]
GALLONS GREASE INTERCEPTOR CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [
]
GALLONS DOSING TANK CAPACITY [
]GALLONS @[ ]DOSES PER 24 RRS #Pumps
D [ 375 ] SQUARE FEET Drainfield New SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE'SYSTEM: [ ],STANDARD [ ] FILLED [XI MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED . [ ]
N
F LOCATION OF BENCHMARK: Top Of Culvert
I ELEVATION OR PROPOSED SYSTEM SITE [ 1.50 j [I INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 0.50 ][dNCHES FT ] ABOVE BELOW] BENCHMARK/REFERENCE POINT
L
D
0
T
R.
E
R-
HEQUIHEU: tZU.UUJ INCHES EXCAVATION REQUIIEu: t J 1Ncnn:S
system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
9pd•
SPECIFICATIONS B\:` Hunter A Collier _TITLEt Environmental Specialist I
APPROVED BY: nu � A TITLE: Environmental Specialist I St. Lucie CHD
Gunter A Comle'r��
DATE ISSUED: 06/14/2019 EXPIRATION DATE: 12/14/2020
DE 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 o£ 3
v 1.1.4 "1416485 SE1190016
NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such
proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for
administrative hearing must be in writing and must be received by the Agency Clerk for the
Department, within twenty-one (21) days from the receipt of this order. The address of the
Agency Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency
Clerk's 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
constitute a waiver of your right to an administrative hearing, and this order shall become a 'final
order.
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.
xi Ad
; St. Lucie County Health Department
Ff irr a 5150 NW Milner Dr Port Saint Lucie, FL 34983
HEALTH
PAYING ON: i 56-SF-1953018 BILL DOG u:56-BID-4203495 CONSTRUCTION APPLICATION * AP1416485
RECEIVED FROM: Alexander J. Piazza PSM, Inc John Erick AMOUNT PAID: $ 515.00
PAYMENT FORM: CREDIT CARD PAYMENT DATE: 05/29/2019
MAIL TO: (Port St. Lucie Properties, Inc)
FACILITY NAME:
PROPERTY LOCATION:
5713 Seagrape or
Fort Pierce, FL 34982
34
Lot:
21
Block:
Property ID: 3402-609-0027-000-7
EXPLANATION or DESCRIPTION:
128 - OSTDS Construction System Inspection Research Fee
-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 - OSTDS Construction System Inspection
133 - OSTDS Construction Reinspection
QUANTITY FEE
1 $
5.00
1 $
15.00
1 $
100.00
1 $
100.00
1 $
115.00
1 $
55.00
1 $
75.00
1 $
50.00
RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-3966372
9=. STATE OF FLORIDA
` ' a DEPARTMENT OF HEALTH
_= ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
PERMIT NOS��SI
DATE PAID;
FEE PAID: L
RECEIPT #:
[°/] New System [ ] Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair [ ] Abandonment [ ] Temporary [ 7
APPLICANT:
Port St. Lucie Prooerties. Inc.
AGENT: Alexander J. Piazza PSM, Inc. TELEPHONE: 772-340-7770
MAILING ADDRESS: 619 SW Biltmore Street, Port St. Lucie, Florida 34983
TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE CONSTRUCTED
BY A PERSON 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
LOT: 34 BLOCK: 21 SUBDIVISION:
Indian River Estates Unit 8 PLATTED: 1958
PROPERTY ID #: 3402-609-0027-000-7 ZONING: R I/M OR EQUIVALENT: [ No ]
PROPERTY SIZE: 0.23 ACRES WATER SUPPLY: [',/I PRIVATE PUBLIC [ ]<=2000GPD [ ]>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: 5713 Seagrape Drive, Fort Pierce, FL 34982
DIRECTIONS TO PROPERTY: SEE MAP
BUILDING
Unit Type of
No Establishment
I RESIDENCE
[ ✓ ] RESIDENTIAL [ 7 COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
3 1,338
2
3
4
[ ] Floor/Equipment Drains Other (Specify) GARBAGE GRINDERS/DISPOSALS
o�s=+°r ace+h.uc...b= ran
Alexander J Piazza
SIGNATURE. wig mro.m:. us_i omv DATE: 5-28-19
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
STATE OF FLORIDA APPLICATION # AP1416485
DEPARTMENT OF HEALTH PIT # 56-SF-1953018
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1190016
APPLICANT: Port St. Lucie Properties, Inc
CONTRACTOR / AGENT: Alexander J. Piazza PSM, Inc John Erickson 772-260-5049
LOT: 34 BLOCK: 21
SUBDIVISION: Indian River Estates ID#:3402-609-0027-000-7
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: 0.23 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES------1 / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 345.01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 750.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Top Of Cull
ELEVATION OF PROPOSED SYSTEM SITE 1.50
FT ] [ ABOVE /I BELOW I] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: FT
DITCHES/SWALES: 15 FT
NORMALLY WET: [ ]YES
[X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE:
75 FT NON -POTABLE:
FT
BUILDING FOUNDATIONS: 11 FT
PROPERTY LINES: 5 FT
POTABLE WATER LINES:
25 FT
SITE SUBJECT TO FREQUENT FLOODING?
[ ]YES [X]NO
10 YEAR FLOODING? [ ]YES
IX]N01
10 YEAR FLOOD ELEVATION FOR SITE:
FT[ MSL / NGVD ] SITE ELEVATION: FT [ MSL
/ NGVD
SOIL PROFILE INFORMATION SITE 1
SOIL PROFILE
INFORMATION SITE 2
USDA SOIL SERIES:Lawnwood sand
Munsell #/Color Texture
Depth
10YR 411
Sand
0 To 25
1 OYR 5/1
Sand
22 To 27
10YR 7/1
Sand
27 To 39
10YR 6/1
Sand
39 To 44
10YR211
Spodic Material
44 To 70
1 OYR 211
Sand
70 To 72
USDA SOIL SERIES:Lawnwood
Munsell#/Color
sand
Texture
Depth
10YR 4/1
Sand
0 To 24
1 OYR 5/1
Sand
23 To 27
10YR 711
Sand
27 To 39
1 OYR 611
Sand
39 To 43
10YR 211
Sand
43 To 63
10YR'2/1
Spodic Material
63 To 70
1 OYR 211
Sand
70 To 72
OBSERVED WATER TABLE: INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 22 INCHES [ ABOVE / HE] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: IX]YES [ ]NO DEPTH: 22.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: INCHES
DRAINFIELD CONFIGURATION: I ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
- REMARKS/ADDITIONAL CRITERIA
WSWT determined using USDA WSS and soil borings. IOYR 5N stripping in 10YR 4/1 matrix > 10%with diffuse boundaries starting
at 22" in SB7. S61 1.5" below BM. SB2 1.5" below BM.
SITE EVALUATED BY:
DATE: 06/12/2019
Collier, Hunter (Title: Environmental Speciali
DR 4015, 08/09 (Obsoletes previous editions which may not be used)
I
1) (Florida Department of Health in St. L
Incorporated: 64E-6.001, FAC
AP1416485 EID1953018
Page 3 of 4
v 1.0.2
APPLICANT'S N
Port St. Lucie Properties, Inc.
LEGAL. DESCRIPTION: Lot 34, Block 21, Indian Riyer Estates Unit 8 (PB 10, PG 73)
' PROPOSED SEP?X$P".7� PQRNf��i011�:
I certify that there are no potable private wells within 75 feet of the available area for the
proposed septic system that there are no non -potable wells within 50 feet of the available area
for the proposed septic system,. that there are no wells within 25 feet of a pesticide -treated
building foundation, that there are no public wells that serve less than 25 people or less than
15 homes or businesses within 100 feet of the proposed septic system, that there are no public
wells that serve more than 25 people or more than 15 homes or businesses within 200 feet of
the proposed septic system, that the water line from the watef meter or well to the structure is
at least 10 feet from the available area for the proposed septic system unless the plans show
the line to be double sleeved, that there is not a gravity sewer line, low pressure sewer line or
vacuum sewage line in a public easement or right-of-way that abuts the property, that there
are no lakes, streams, wetlands, or surface water within 75 feet of the available area for the
proposed septic system unless the property was created prior to 1972, that the septic system is
proposed on the.side of the lot farthest from surface water, that all private wells, septic
systems and surface water on adjacent or contiguous land within 75 feet of the applicant's lot
are shown on the site plan, that all public wells within 200 feet of the applicant's lot are
shown on the site plan, and that the location of building or residences, swimming pools,
recorded easements, paved areas or driveways, sidewalks, the general slope of the property,
filled areas, drainage features, and surface waters such as lakes, ponds, streams, canals, or
wetlands are shown on the applicants lot.
The natural grade elevation in the area of the proposed septic system and the benchmark must
be shown on the site plan. Please locate the benchmark within 200 feet of the proposed septic
system.
NOTE: MUST BE CERTIFIED BY A FLORIDA
REGISTERED SURVEYOR OR ENGINEER.
um+awTeer�..wa, °�.
Alexander Piazza
CERTIFIED BY:
FLORIDA PROFESSIONAL NO.: 6330
DATE: 05/28/19 JOB NO.: 19-4626
docstforms/septics/Sep ticApppPage207
Sb STATE OF FLORIDA PERMIT #.
DEPARTMENT OF HEALTH
pi ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
APPLICANT: Port St. Lucie Properties, Inc. AGENT: Alexander J. Piazza PSK Inc.
LOT: 34 BLOCK: 21 SUBDIVISION: Indian River Estates
PROPERTY ID # : 3402-609-0027-000-7 [ 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: [✓]
YES [ ]
NO NET USABLE AREA AVAILABLE: 0.23
ACRES
TOTAL ESTIMATED SEWAGE FLOW:
500
GALLONS
PER DAY [RESIDENCES -TABLE I/0THER-TABLE2
1
AUTHORIZED SEWAGE FLOW:
GALLONS
PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE
]
UNOBSTRUCTED AREA AVAILABLE:
750
SQFT
UNOBSTRUCTED AREA REQUIRED: 750
SQFT
BENCHMARK/REFERENCE POINT LOCATION:
ELEVATION OF PROPOSED SYSTEM SITE IS34 [ INCHES /Ff ] [ABOVE/BELOW'] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE 'WATER:100 FT DITCHES/SWALES:15 FT NORMALLY WET? [ ] YES ]✓I NO
WELLS: PUBLIC: 200 FT LIMITED USE:100 FT PRIVATE: 75 FT NON—POTABLE:100 FT
BUILDING FOUNDATIONS:5 FT PROPERTY LINES:10 FT POTABLE WATER LINES: FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [✓] NO
10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD
bu1L rL vz 1 11VC V14`]H'xluv b'l'wjY 1
MUNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
10 YEAR FLOODING? [ ] YES [✓] NO
SITE ELEVATION: FT MSL/NGVD
bulb rktuk'lLz 1AZUMIIH'Xuy blwz
MUNSELL #/COLOR TEXTURE
USDA SOIL SERIES:
DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
OBSERVED WATER TABLE:40+ INCHES [BELOW t] EXISTING GRADE. TYPE:[ PERCHED/ APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [.ABOVE/BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: 1 ] YES [ ] NO MOTTLING: [ ] YES [ ] NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: INCHES
DRAINFIELD CONFIGURATION- IV] TRENCH [ ] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA:
AlexanderJ Piazza W ;� mnnm,w o naoawrmei ew aooism.a uom ar
52TE EVALUATED BY: wo-roieasvos�ssasw DATE: 5-28-19
)H 4015, 12/11 (obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4