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STATE OF FLORIDA
CENTRAX #:
56-SF-08523
_
'--,-'�
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
DATE PAID:
FEE PAID :
$
CONSTRUCTION PERMIT
RECEIPT
OSTDSNBR
05-0643- -N
CONSTRUCTION PERMIT
FOR:
[ X 1New System [
]Existing System [
]Holding Tank [ ]
Innovative Other
F ]Repair [
]Abandonment [
]Temporary [ ]
SCANNED
APPLICANT: Louran Builders AGENT:WILLIAM BENNETT
BY
.PROPERTY STREET ADDRESS: Sunset Blvd Fort
Pierce FL 34982
St. Lucie County
LOT: 21 BLOCK:
64 SUBDIVISION:
Indian River Estates
[Section/Township/Range/Parcel No.]
PROPERTY ID #:.^--
[OR TAX ID NUMBER]
SYSTEMXMUST-BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E-6,FAC
DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
PERIOD. 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,j
PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM f
COMPLIANCE WITH OTHER FEDERAL, STATE.. OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT.
SYSTEM DESIGN AND 'SPECIFICATIONS
T [ 900 ]Gallons SEPTIC TANK
A [ 0 1.Gallons
N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY
K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0
MULTI-CHAMBERED/IN .SERIES: [Y
MULTI-CHAMBERED/IN SERIES: [Y
]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0
D[ 462 ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [, 0 ]SQUARE FEET
SYSTEM
A -,TYPE SYSTEM: [ N
]STANDARD
[ N ]FILLED
I CONFIGURATION: [ N
]TRENCH
[ Y ]BED
N
F •`,LO,CATION TO BENCHMARK: C/L
of Savanna
Rd. @ West Pr
Y ] MOUND N ]
N I-
L ELEVATION OF'PROPOSED SYSTEM SITE [ ] [ INCHES ] [ ABOVE] BENCHMARK/REFERENCE POIN
E., BOTTOM OF DRAINFIELD TO BE [ 7.0 ] [ INCHES ] [ ABOVE] BENCHMARK/REFERENCE POINT
L ,,
D ,.FILL REQUIRED:[ 22.0 11NCHES EXCAVATION REQUIRED:'[ 84.0 ] INCHES
(1TAC4 ARMLA KC -
The licensed contractor installing the system is responsible
category of tank in accordance with a. 64E-6.013(3)(f), PAC.
Home stubout invert to be 19 inches above reference point.
-Excavate 41'x14'x7' deep.
SPECIFICATIONS BY: POLISSKY, JODI TITLE:
??�^
APPROVED BY:
Polissky, Jodi ( TITLE:
Environmental Spec St. Lucie
CHD`'
DATE ISSUED:
12/13/05
EXPIRATION DATE: 6/13/07
DH 4016, 03/97
(Obsoletes previous editions which may not be used)
(Stock Number:
5744-001-4016-0) (0etda -cone- 4016-1]
Page
g
1 of 2
1H6
STATE OF FLORIDA
�- DEPARTMENT OF HEALTH
ONSITE SEWAGE DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SP',
i
APPLICANT: Louran Builders
CENTRAX #: 56-SF-08523
OSTDSNBR : 05-0643-N
AGENT: WILLIAM BENNETT i
LOT: 21 BLOCK: 64 SUBDIVISION: Indian River Estates ID#: ---
e
,TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S
MUST PROVIDE REGISTRATION NUMBER
PROPERTY SIZE CONFORMS TO SITE PLAN: [XI YES [ ]NO NET USABLE AREA AVAILABLE: 0.30 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [64E-6, TABLE 11
AUTHORIZED SEWAGE FLOW: 450 GALLONS PER DAY [1500GPD/ACRE OR 2500GPD/ACRE] ..
UNOBSTRUCTED AREA AVAILABLE: 1300 SQFT UNOBSTRUCTED AREA REQUIRED: 923 SQFT
BENCHMARK/REFERENCE POINT LOCATION: C/L of Savanna Rd. W West Property Line
ELEVATION OF PROPOSED SYSTEM SITE IS 3.00 [ INCHES ] '[ ABOVE ]BENCHMARK/REFERENCE POINT.
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES:'
SURFACE WATER: N/A FT DITCHES/SWALES: 15 FT NORMALLY WET? [ ]YES I X INO�
WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: 75 FT NON -POTABLE: N/A FTi
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 11 FT POTABLE WATER LINES: N/A FT'
SITE SUBJECT TO FREQUENT FLOODING:- [ ]YES [ X ]NO 10 YEAR FLOODING? [ ]YES [ X ]NO'
10 YEAR FLOOD ELEVATION FOR SITE: 0 FT NGVD SITE ELEVATION: 0 FT NGVD
SOIL PROFILE INFORMATION SITE 1
Munsell #/Color Texture Depth
10VR-4/1-V n GV yjnw RanA 0 to 4
10VR-5/1-GY Vine Sand 4 to 7
`10YR-6/1-GY Rinw Sand 7 to 99
10YR-7/1-1. GY Fina Sand 77 to 44
10VR-7/1_RR Tlar an 44 to ZR
10YR-2/1-RR Rafncal 4R to 79
to
to
USDA SOIL SERIES: 21 Lawnwood San
SOIL PROFILE INFORMATION SITE 2
Munsell #/Color Texture Depth
10YR-4/1-V TI GY Fina Sand 0 to 6
l OVR-6/1-GY Fina Sand 6 to 94
1OVR-7/1-T. QV_ Finn Sand 24 to 16:,-
9nVR-9./1-R8 _wgrdpan 46 to 40
10YR-2/3.-BK RPfnaa7 40 to
to
to
to
USDA SOIL SERIES: 21 LawnWOOd San `'-
OBSERVED WATER TABLE: 20.00 INCHES [ BELOW ] EXISTING GRADE TYPE: [PERCHED _,]
ESTIMATED. WET SEASON WATER TABLE ELEVATION:20.00 INCHES [ BELOW ] EXISTING GRADE.
H.TGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: 0.0 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING:Fine Sand/0.65 DEPTH OF EXCAVATION:84.0 INCHES
C?RAINFIELD CONFIGURATION: [ ]TRENCH [ X ]BED [ ]OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA:
SITE EVALUATED BY: JOHN HANSON
DH 4015, 03/97 (Obsoletes previous editions which may not be used)
(Stock Number; 5744-003-4015-1) [ostds_eval_4015-3]
DATE: 11/18/05
.i
Page 3 of 3
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Fee Received: $ Receipt No: Check
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