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Home My WebLink AboutD O H PAPERWORKf STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL APPLICANT: Craig E AGENT: AlexanderJ. PROPERTY ADDRESS: LOT: -1:1 / % O /- oe-/- 7(o John Erickson 772-260-5049 n Rd Pori Saint Lucie. FL 34987 BLOCK: APPLICATION a:AP1389631 PERMIT n:56-SF-1911667 DOCUMENT a:F1.1317103 DATE PAID:.12/26/2018 FEE PAID:515.00 RECEIPT u.:56-PID-3834182 ST. Lucie County, Permitting SUBDIVISION: IDH : 4215-223.0001-000.4 CHECKED [XI ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION SETBACKS [ ] [Ol] TANK SIZE [1] 1090,00 12.1 [ ] 1271 SURFACE WATER 100 FT [ 1 [021 TANK MATERIAL Polypropylene [ ] (2B] DITCHES FT [ 1 (031 OUTLET DEVICE [ ] [291 PRIVATE WELLS 76 FT [ 1 (043 MULTI -CHAMBERED [ Y N I [ 1. [301 PUBLIC WELLS FT [. ] [051 OUTLET FILTER Polylok PL-68 [ ] [311 IRRIGATION WELLS FT [ ] [061 LEGEND 1. 70-143-11DC4 2. [ ] [321 POTABLE WATER 55 FT [ 1 (071 WATERTIGHT [ ] [331 BIIILDING FOUNDATIONS 7 FT [ 1 ['081 LEVEL [ ] 1341 PROPERTY LINES 75 FT [ 1 [097 DEPTH TO LID [ 1 [351 OTHER FT DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM (� [ 1 [101 AREA [11 500 [21 SQFT [ 1 [361 DRAINFIELD COVER [ ] [11] DISTRIBUTION BOX _HEADER x [ ] [371 SHOULDERS `�0/0 [ ] [121 NUMBER OF DRAINLINES 1. 5.00 2. [ ) [381 SLOPES [ 1 [131- DRAINLINE SEPARATION [ 1 [391 STABILIZATION 08/27/2019 [ ] (141 DRAINLENE SLOPE 'y [ ] (151 DEPTH OF COVER ADDITIONAL INFORMATION [ ] (161 ELEVATION [ ABOVE / BELOW IBM 11.00 [ 1 [401. UNOBSTRUCTED AREA [ ] [171 SYSTEM LOCATION [ ] [41] STORMWATER RUNOFF [ 1 [181 DOSING PUMPS [ ] [421 ALARMS [ 1 [191 AGGREGATE SIZE [ 1 [431 MAINTENANCE AGREEMENT [ 1 (201 AGGREGATE EXCESSIVE FINES [ ] (441, BIIILDING AREA [ I [211 AGGREGATE DEPTH [ 1 (451 LOCATION CONFORMS WITH SITE PLAN FILL / EXCAVATION MATERIAL ` [ 1 [471 CONTRACTOR (OWNER) [ 1 [221 FILL AMOUNT [ 1 [481 OTHER INFILTRATOR E036 (Single Chambe [ ] (231 FILL TEXTURE [ 1 1241 EXCAVATION DEPTH ABANDONMENT [ ] [251 AREA REPLACED [ 1 [491 TANK PUMPED [ 3 [263 REPLACEMENT MATERIAL [ 1 [50] TANK CRUSHED & FILLED Comments: Comments are on page 2. CONSTRUCTION [ APPROVED / .DISAPPROVED ] St. FINAL SYSTEM [ APpROVED / DISAPPROVED ]: _ Si Environmental Speelall Brian J Ingram (ENVIRONN (Explanation of Violations on following page) DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, PAC EH Database v 1.0.1 AP1389631 E101911667 Lucie CHD DATE: 08119/2019 NTAL HEALTH) Lucie CHD DATE: 08/27/2019 Page 2 of 3 Violation Number STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL Comment APPLICATION a:AP1389631 PERMIT a:56-SF-1911667 nocmmENT t):F11317103 DATE PAID:12/26/2018 FEE PAID;515.00 RECEIPT a:56-PID-3834182 The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300 ST, filter, and 5x4 long TRENCH DF installed. No violations, system ok to cover. Owner notified onsile. Needs final ction1for mound system and final site grading, Final system approved. Owner and building department emailed final DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 2 of 3 EH Database v 1.0.1 AP1389531 EID1911667 I PERMIT #:56-SF-1911667 STATE OF FLORIDA APPLICATION u:AP1389631 DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: SYSTEM FILE C®PY RECEIPT i): DOCUMENT #: PR7198353 CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Cralo & Lauren Stokes PROPERTY ADDRESS: 11100 Carlton Rd Port Saint Lucie, FL 34987 LOT: BLOCK: SUBDIVISION: SCANNED PROPERTY xD U: 4215-223-0001-000-4 [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 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 T [ 900 ] GALLONS / GPD Septic 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 8[ ]DOSES PER 24 HRS t[Pumps [ ] D [ 500 ] SQUARE FEET Drainfield new SYSTEM R [ ] SQUARE FEET [.]/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [X] FILLED I MOUND [ ]_ I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: Site BM Set IRC SE of system I ELEVATION OF PROPOSED SYSTEM SITE [ 7.00 ][ INCHES FT ][ABOVE E BOTTOM OF DRAINFIELD TO BE [ 11.00 ] [ INCHES FT ] [ ABOVE L D I 0 T H E R BENCHMARK/REFERENCE POINT BENCHMARK/REFERENCE POINT 1LL a Vuls u: t'14.UU] INCHES EXCAVATION REQUIRED: [ ] INCHES The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300 gpd. SPECIFICATIONS BY: Brian J TR9=BM TITLE: Environmental Specialist APPROVED BY: ITLE: Environmental Specialist II Brian J Ygrain DATE ISSUED: 01/15/2016r EXPIRATION DATE: DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC v 1.1.4 A 1389631 SE1147796 IZ St. Lucie CHO 07/15/2020 Page 1 of 3 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. St. Lucie County Health Department iafiaa 5150 NW Milner Dr Port Saint Lucie, FL 34983 HEALTH PAYING ON: PERMITM56-SF-1911667 elLLoocu:56-BID-4056674 CONSTRUCTION APPLICATIONMAP1389631 RECEIVED FROM; Alexander J. Piazza PSM, Inc Jahn Erick AMOUNT PAID: $ 515.00 PAYMENT FORM: CREDIT CARD PAYMENT DATE: 12/26/2018 MAIL TO: Craig & Lauren Stokes FACILITY NAME: 11100 Carlton Rd Port Saint Lucie, FL 34987 Lot: Block: Property ID: 4215-223-0001-000-4 EXPLANATION or DESCRIPTION: QUANTITY FEE 128 - OSTDS Construction System Inspection Research Fee 1 $ 5.00 -1 -,Surcharge (All) 1 $ 15.00 -1 - OSTDS New Permit Surcharge 1 $ 100.00 -1 - OSTDS Construction Application and Plan Review,New 1 $ 100.00 123 - OSTDS Construction Site Evaluation 1 $ 115.00 126 - OSTDS Construction Permit (New or Mod, Amendment) 1 $ 55.00 127 - OSTDS Construction System Inspection 1 $ 75.00 133 - OSTDS Construction Reinspection 1 $ 50.00 RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-3834182 �rnE STATE OF FLORIDA FILE COPY ` DEPARTMENT OF HEALTH Q ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: 5?-z I flo(o PERMIT NO. J'ID`S��I�[��OiJ^I DATE PAID: FEE PAID: W[ RECEIPT #: r)V—Cjj New System [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT: Craig & Lauren Stokes AGENT: Alexander J. Piazza PSM, Inc. TELEPHONE: 772-340-7770 MAILING, ADDRESS: 619 SW Biltmore Street, Port St. Lucie, Florida 34983 TO BE C6MPLETED 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: - BLOCK: PROPERTY ID # SUBDIVISION: 4215-223-0001-000-4 PLATTED: ZONING: R I/M OR EQUIVALENT: [ No ] PROPERTY SIZE: 17.451 ACRES WATER SUPPLY: [�(] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: 11100 Carlton Road, Fort Pierce, FL 34987 DIRECTIONS TO PROPERTY: SEE MAP BUILDING INFORMATION [,i] RESIDENTIAL [ ] COMMERCIAL Unit Type of No. of Building Commercial/Institutional System Design No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC 1 RESIDENCE 3 1,436 2 3 4 [ ] Floor/Equipment Drains Other (Specify) GARBAGE GRINDERS/DISPOSALS Oi 11' '.f V...M 1Pi,va Alexander J Piazza o :�s. Nm „�. M427 IIM f.!' 6IXApfi m. e.o nEvI SIGNATURE: u�. eaia,:.m 1.2 mm DATE: DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC 12-18-18 Page 1 of 4 STATE OF FLORIDA . APPLICATION N AP'1389631 DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM PERMIT 56-SF-1911667 8 8 SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT SE1147796 APPLICANT: Craig & Lauren Stokes CONTRACTOR / AGENT: AlexanderJ. Piazza PSM, Inc John Erickson 772-260-5049 LOT: BLOCK: SUBDIVISION: ID#: 4215-223-0001-000-4 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: 17.50 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 26250.00 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: ELEVATION OF PROPOSED SYSTEM SITE Site BM set IRC SE of system 7.00 [FINCHES] / FT ] [ ABOVE / BELOW ] BENCHMARH/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: 100 FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 75 FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 50 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO] 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:Pineda sand Munsell #/Color Texture Depth 1 OYR 616 Sand O To 7 10YR 5/6 Sand 7 To 16 1 OYR 413 Sand 16 To 22 10YR 5/1 Sand 22 To 35 1 OYR 5/8 CMN/PRM RF 28 To 35 7.5YR 8/4 Sand 35 To 42 10YR 6/8 Sand 42 To 50 10YR 813 Sand 50 To 54 1 OYR 5/2 Sandy Loam 54 To 60 10YR 5/2 Sandy Clay Loam 60 To 72 USDA SOIL SERIES:Pineda sand Munsell #/Color Texture Depth 10YR 5/6 Sand 0 To 7 10YR 4/2 Sand 7 To 18 10YR 5/2 Sand 18 To 37 10YR 518 CMNIPRM RF 29 To 37 7.5YR 814 Sand 37 To 44 10YR 812 Sand 44 To 57 10YR 5/2 Sandy Clay Loam 57 To 72 OBSERVED WATER TABLE: 65.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 28 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 28.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.60 DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: [ ] TRENCH [XI BED [ ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA WSWT determined using USDA WSS and soil borings. 10YR518 CMN PROM RF mottling In 10YR511 matrix >2% starting at 28" In SB1. SB7 T' below BM. SB2 6" below_SM. SITE EVALUATED BY: 6 Ingram, Brian DH 4015, 08/09 (Obeoletes previous editions d Environmental Specialist III (ENVIRONMENTAL HEALTH) may not be used) Incorporated: 64E-6.001, FAC AP1389631 EID1911667 INCHES DATE: 01/04/2019 Page 3 of 4 v 1.0.2 {l1E yL STATE OF FLORIDA i r DEPARTMENT OF HEALTH t' ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM \ SITE EVALUATION AND SYSTEM SPECIFICATIONS PERMIT # .56 SL ,y// [a(o7 APPLICANT: Craig & Lauren Stokes AGENT: Alexander J. Piazza PSM, Inc. LOT: - BLOCK: - SUBDIVISION: PROPERTY ID #: 4215-223-0001-000-4 [Tax ID Number 1 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: 17.451 ACRES TOTAL ESTIMATED SEWAGE FLOW: 500 GALLONS PER DAY [RESIDENCES-TABLET/6THER-TABLE2 ] 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 IS 34 [INCHES/FT J [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? [ I YES 1✓1 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 FLOODING? [ ] YES [✓1 NO 10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD SOIL PROFILE INFORMATION SITE 1 MUNSELL #/COLOR TEXTURE DEPTH TO TO TO TO TO TO TO TO TO USDA SOIL SERIES: OBSERVED WATER TABLE:40+ INCHES [BELOW ESTIMATED WET SEASON WATER TABLE ELEVATION:_ HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING:_ DRAINFIELD CONFIGURATION: [✓] TRENCH [ ] BED REMARKS/ADDITIONAL CRITERIA: SITE EVALUATED BY: Alexander J Piazza SOIL PROFILE INFORMATION SITE 2 MUNSELL #/COLOR TEXTURE USDA SOIL SERIES: DEPTH TO TO TO TO TO mn 1'V TO TO 11 EXISTING GRADE. TYPE: [PERCHED /APPARENT ] _ INCHES [.ABOVE/BELOW ] EXISTING GRADE MOTTLING: [ J YES [ ] NO DEPTH: INCHES DEPTH OF EXCAVATION: INCHES [ ] OTHER (SPECIFY) 12-18-18 ]H 4015, 12/11 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 Of 4 59- R9ira6 APPLICANT'S NAME: Craig & Lauren Stokes Sy.fc 19116(07 LEGAL DESCRIPTION: 4215-423-0001-000-4 RMMMIRMATION, 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 water 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. d91uIIYt19nMIryNNunderl Pbvu orv:cy;o�uiuinortM Alexander) Piazza �-��,xxcamoxeseix�scsca000xsal. m.nle.1Mer1 CERTIFIED BY: Dale 2018.12.18 IUi¢s>uasYd FLORIDA PROFESSIONAL NO.: 6330 DATE: 12/18/18 I013 NO.: 18-4297 docs/fonT s/septics/Stp (icApppPage207 Mission: To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. t, FUrlda HEALTH Vision: To be the Healthiest State In Rick Scott Governor Celeste Philip, MD, MPH State Surgeon General and Secretary Florida Department of Health in St. Lucie County Conditions for Issuance of Water Well Permits Effective July 24, 2017 • Contact the Florida Department of Health in Saint Lucie County (FDOH — St. Lucie) prior to constructing or abandoning any well. a. Call the FDOH — St. Lucie Well Line at 772-873-4936 or email SLCDOH-WELLS(cD-FLH EALTH. GOV b. Provide the following information: i. Permit number ii. Driller name iii. Address iv. Date and time to begin construction/abandonment • A minimum of 24 hours' notice is required before constructing any public water supply wells. Please call our main office at 772-873-4931 and speak with Environmental Health Staff or provide notification by email to SLCDOH-WELLS(a)FLHEALTH.GOV • Submit revisions to permit and/or site map and associated fee within 48 hours of well construction or abandonment. Florida Department of Health St Lucid County • Division of Disease Control and Health Protection Bureau of Environmental Health 5150 NW Milner Drive Port St. Lucie, FL 34983 PHONE: 7721873-4931 •FAX: 7721595-1306 FloridaHealth.gov Accredited Health Department Public Health Accreditation Board :sErnc.-dt % -SF:- 191 ILM-1 =FLQR1DA PERMIT PelvIl*TION TO CONSTRqCT, ODIFY, OR A13ANDONIA WELL OS6utfteat • p4rrnitN,4� 59-29166 ON "Orttivve6t 1711-1-OUT&I- efiPgfi �-Lrenotes'Requlm 'N s Where APP11cable) F�odda Unique ID " � I,'! L Pennit Stipuldi ona,Requred D 6L Johns River (See Attached) 4 KS cuftFIbrida nnge River qu�a- " piddsrmmnnANmuNfngtjM f4�rf*; wwre Opp, Ye4i'k effneaffon 1:1 Rechar Recover cc Tu 22. Laffluillo7 1, 1 = 23.'Data,Obtained Fro 37, Sttude �Lot Block 'Unit) e , "County ounly ChecRAV-52<1 YO[al:No Sug-dMsion 11352 954-818-496,9 - downtheh2le net` ',Vpenls,q Number 'TelephoheNurriber Port St; Lucie F1 34988. 0, Nl9�dlfiqaffcn[1 City Abaruionment State z �,p 'n Aquifer fL stal(less dielel JAN "22 201! Stalrile 1t;6tvanized PVC se r I L 1'. - I ss Si - Auger Cable Tool .10tt I ,71 e& tSonic Hand Driven (VVell Point, Sand P61mi Hy ra jc�polnt(Dlroctpush) 7: List number of eztsgng unused Wejla;Wrlsite do -----7— own I 'tr U ou , rova - r I tv e Under pt;qnsumpt1w ate cc to '110 Unn ',,PYPMcovU r, Use Permit (CUPNvup) P.isfiidtWell IDNo. I IWUvYKVeLt TEDA RITY. THE jj lN.MENT&CnTTlE:s- Tlo � I : .- . I Pend lof 2 tbq 1B" 100.10' y 5'x4.0' CUNC POLE ® ❑ rTYPI AL ND CONC / (p6 34, PG 35) ' MONUMENT_ _ / X — X — rw w� p N A 4' WIRE 37.7 S 0 DPL 1°i+ x x x— x FENCE CORNER W 24.72 x __ k __ % x x 24.93 4' WIRE �OF PCbR6x — % — x x X X FE&E END I PROPOSED FENCE CORNER !!!!! 31.4'S OF PL N 35.2'S OF PL aIt% 7 271.21' +ry 24.78 C.ONC ryhd, OgBANDONED ElECT81C p�p5F , WELL PANEL a s.ONaBs�@{107,. 50.8T 10'x17, CONC y;�+ �,_ 6' PROPOSE n METAL SNED :�sd:;F,€+°,%,rRESIDENC ' xp 270.68' N O1 � 6 •'4 67 00 M1— COLUMN 25.68 0'. DIRT DRIVE EI�RyD / Xp \ � COLUMN 24.89 X X X% SITE BENCHMARK PON x x SET "AJP TRAVERSE" I �E = 26.48 NAVD,1-988 O O TE",'a x \ / I�g I'GL K METAL X9ig x I56.01' x x ^ COVERED m . I—x x —X -/rx —x —X —X --X 4' W1RF F ICALJ —_ T I O A�ALDONED