HomeMy WebLinkAboutD O H PAPERWORK:-
FILE
-COPY
PERMIT #: 56-SF-1910780
STATE_OF_FLORIDA—
APPLICATION a_:.AP_1.3889-7--1
DEPARTMENT OF HEALTH
ONSITE SEWAGE
DATE PAID:
TREATMENT AND DISPOSAL
FEE PAID:
-����¢`•
SYSTEM
„
RECEIPT #:
DOCUMENT It: PR1198387
CONSTRUCTION PERMIT FQR: - OSTDS New SCANNED
APPLICANT: Bradle & Brittany MurrayBY
PROPERTY ADDRESS: 4912 Pinetree Dr �For[ Pierce, FL 34982
LOT: 10, 11, & 12 BLOCK: 3 SUBDIVISION: Indian River Estates
PROPERTY ID #: 3402-602-0092-000-2 [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 PERIODOF 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
t
A [ ] GALLONS / GPD NIA CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY -[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY_ [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
D [ 500 ] SQUARE FEET Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD (X] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [X] BED [ ]
N
F LOCATION OF BENCHMARK: Site BM Orange paint triangle CC Of Rd, Center Of Drom
I ELEVATION OF PROPOSED SYSTEM SITE [ 4.00 ][ INCHES FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 7.00 it INCHES FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D
O
T
H
E
R
SP
FILL REQUIRED: [15.001 INCHES EXCAVATION REQUIRED: [ ] INCHES
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a totalestimatedFlow of
300 gpd.
RECEIVED
JAN 14 2019
Farmltting
ECIFICATIONS BY:
,.-APPROVED BY:
r DATE ISSUED:
,DH 4016, 08/09
Incorporated:
--'- - ---7 "' ------ Environmental Specialist II
6M^^4+FTLE: Environmental Specialist II St. Lucie CHO
Hilan J Ingr
0111512019 EXPIRATION DATE: 07/15/2020
(Obsoletes all previous editions which may not be used)
64E-6.003, PAC Page 1 of 3
v 1.1.4 F 1398971. SE1147378
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 IM68, 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.
(k,
St.-Lucie_C.ounty_Health-Department -
01PC 3 5150 NW Milner Dr Port Saint Lucie, FL 34983
HEALTH
PAYING ON: PERMIT a,56-SF-1910790 BaLDOC#56-BID-4055136 CONSTRUCTION APPLICATIONM AP1388971
RECEIVED FROM: Pace 2000 Inc AMOUNT PAID: $ 515.00
PAYMENT FORM: CHECK 5512 . ' ' PAYMENT DATE: 12/20/2018
MAIL TO: Bradley & Brittany Murray
FACILITY NAME:
PROPERTY LOCATION:
4912 Pinetree Dr
Fort Pierce, FL 34982 -
10,11,&12 3
Lot: Block:
Property ID: 3402-602-0092-000-2
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-3832325
A_, PLICATION FOR:
L x ] New System
[' `] Repair
AGENT:
MAIL2IQG ADDREss: V-
ISPOSAL
i
T
PERMIT NO.
DATE -PAID i
i
FEE PAID:
RECEIPT #:
ing System L ] Holding Tan)c [ , ] Innovative
[] Abandonment [ ] Temporary [ ]
TELEPHONE K�7G-3i�U
TO BE. COMPLETED By AP
YL-ICANT 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/6j,/�, BLOCK:
�-_7� n `S�i7BD2VISIOIQ:� PLATTED: l g-5
PROPERTY ID it: /Jl`Ili2.^IAL%Z^�J��%-���n'� ZVNING: IIM OR EQUIVAE.r
firENT: L Y I DT ]
.
PROPERTY, SIZE: i�� ACRES WATER SUPPLY: [ ] PRIVATEPUBLIOCXI<=2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y'/ 1;
PROPERTY ADDRESS:
DIRECTIONS TO PROPERTY:
P
BUILDING INFORMATION
Unit- Type of
No Establishment
2 1 4�- - / -
g"Ll /
4
[ ] Floc
SIGNATURE:
L 1>2000GPD
DISTANCE TO SEWER: /i,��FT
n
1)(13 RESIDENTIAL [' ] COMMERCIAL
No, of Building Commercial/Institutional System Design
Bedrooms Area Sgft,Table 1,.Chapter 64i-G FAC
3 ,-------------
42 9l�?0.ss
(Specify)
DH 4015, .08/09 .(Obsoietes previous editions I'll-ich may not be used)
Incorporated 64E-6.001, FAC
DATE: 12 + 91 18
Page 1 of 4
.;, STATE OF FLORIDA APPLICATION R AP1388971
DEPARTMENT OF HEALTH— —
R 1-- - - - PERMIT # 56-SF-1910780
ONSITE SEWAGE TREATMENT AND. DISPOSAL SYSTEM
,X S' SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT H SE1147378
APPLICANT: Bradley & Brittany Murray
CONTRACTOR / AGENT: Pace 2000, Inc -
LOT: 10, 11. & 12 BLOCK: 3
SUBDIVISION: Indian River Estates IIDO: 3402-602-0092-000-2
TO BE COMPLETED BY ENGINEER,
HEALTH `DEPARTMENT EMPLOYEE, OR
OTHER QUALIFIED PERSON.
ENGINEERS MUST PROVIDE
REGISTRATION NUMBER AND SIGN AND SEAT. EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES [.]NO
NET USABLE AREA AVAILABLE: 1.36 ACRES
TOTAL ESTIMATED SEWAGE FLOW:
300 GALLONS PER DAY
(
RESIDENCES -TABLET
/ OTHER -TABLE 2 j
AUTHORIZED SEWAGE FLOW:
3400.02 GALLONS PER DAY.
[ 1506 GPD/ACRE
OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE:
900.00 SQFT -i1 UNOBSTRUCTED AREA REQUIRED:
750.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: site BM orange paint triangle CL of Rd, cei
ELEVATION OF PROPOSED SYSTEM SITE 4.00 CLINCHES / FT ] [ ABOVE /
BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM
TO THE FOLLOWING FEATURES
SURFACE WATER: FT
DITCHES/SWALES: 30 FT
NORMALLY WET: [ ]YES
[X]NO
• WELLS: .PUBLIC: FT LIMITED
USE: FT - PRIVATE:
FT NON -POTABLE:
FT
BUILDING FOUNDATIONS: 5 FT
PROPERTY LINES: 25 FT
POTABLE WATER LINES:
80 FT
SITE SUBJECT TO FREQUENT FLOODING?
[ ]YES (XING
10 YEAR FLOODING? [ ]YES
[X]NO]
10 YEAR FLOOD ELEVATION FOR SITE:
FT[ MSL / NGVD ] SITE
ELEVATION: PT [ MSL
/ NGVD
SOIL PROFILE INFORMATION SITE 1 I
RnTT. PPn7TT.7
TN7nRMLTTnN s7TR o
USDA SOIL SERIES:Waveland fine sand
Munsell #/Color Texture _
Depth
1 OYR 6/2
. Fine Sand
0 To 7
10YR 6/1
Fine Sand
I To 36
10YR 7A
Fine Sand
27 To 36
10YR 5/1
Fine Sand
36 To 48
1 OYR 5/2
Fine Sand
48 To 52
1 OYR 3/1
Fine Sand
52 To 58
10YR 2/1
Spodic Material
58 To 72
USDA SOIL SERIES:Waveland fine sand
Munsell #/Color Texture
Depth
10YR 4/1
Sand
0 To 12
10YR .511
Sand
12 To 17
.1OYR 611
Fine Sand
17 To 39
10YR 7/1
Fine Sand
30 To 43
10YR 512
Sand
43 To 55
10YR 313
Sand
55 To 59
10YR 211
Spodic Material
59 To 72
OBSERVED WATER TABLE: 72.00 INCHES [
ABOVE /
BELOW
] EXISTING GRADE
TYPE:
[ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION:
27 INCHES [ ABOVE
/
BELOW ]
EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES
[X]NO MOTTLING: [X]YES
( ]NO
DEPTH: 27.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Fine Sand/0.60 DEPTH OF EXCAVATION%
DRAINFIELD CONFIGURATION: [ j TRENCH ,,,[X I BED [ ] OTHER (SPECIFY)
r REMARKS/ADDITIONAL CRITERIA _
IT determined using USDA WSS and soil borings. '
U11 stripping In 10YR611 matrix >10% with diffuse boundaries starting at'27" in S81 and 30" In SB2.
4" below SM. SB2 2" below BM. /)
'SITE EVALUATED BY:
Ingram, Brian trlI Environmental Spectallstll) (ENVIRONMENTAL HEALTH)
DR '4015, 08/09 (Obsoletes previous editions v ch say not be used) Incorporated: 64E-6.001, SAC
INCHES
DATE: 01/03/2019
'Page 3 of 4
AP1388971 EID1910780
v 1.0.2
STATE OFFLORIDA (a1
RTMENT OFTH
ONSITE SEWAGETMENTANDDISPOSAL SYSTEM
.mSITE EVALUATION AND SYSTEM SPECIFICATIONS
PPLICANT:�c
AGENT
OT: D // BLOCK: 13 SS/U�BDIVISION:�rQ F3� g . C%n � ,n /
ROPERTY ID ik i'��yO L • InOT iY ML—�1.�CJ' % [ Section/Township/Parcel No. or Tax ID Number
O BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINEERS
DST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
ROPERTY SIZE CONFORMS TO SITE PLAN: %� YES [ ] NO NET USABLE AREA AVAILABLE:�ACRES
OTAL ESTIMATED SEWAGE FLOW: GALLONS PER DAY [RESIDENCL•S-TABLEVOTHER-TABLE2 ]
UTHORIZED SEWAGE FLOW: •`,� 0 O._ *, `[- GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE' ]
NOBSTRUCTED AREA AVAILABLE; 6p(7 /— SQFT, . UNOBSTRUCTED AREA �jREQUIRED: 0j 00 '1S/Q�FT
ENCHMARK/REFERENCE POINT LOCATION:. m f-LA � TJ J�J f'"/�'ln1Pi/J % s/'I �(1'0 i / ��() (,ry //• y
LEVATION OF PROPOSED SYSTEM. SITE IS [INCHES/FT Ij [ABOVE/B,� W] BENCHMARK/REFERENCE POINT
HE MINIMUM'SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
URFACE NATER:A.AJ _FT DITCHES/SWALES;�5'0_FT 'NO Y WET? [ ] YES r�i�v NO
ELLS: PUBLIC: �FT LIMITED USE:. DO FT PRIVATE -FT NON —POTABLE: �}�7 FT
UILDING FOUNDATIONS: 40 � FT - PROPERTY LINE S:'... SO / FT ;POTABLE WATER LINES: /�FT
ITE, SUBJECT TO FREQUENT FLOODING:
0 YEAR FLOOD ELEVATION FOR SITE:
TEXTURE
USDA SOIL SERIES:
1
[ ] YES VQ NO 10 YEAR FLOODING?. [ ] YES 'P<l NO
FT MSL/NGVD SITE ELEVATION: FT MSL/1N9VD
.TO '
TO. `
TO
TO
TO
TO
TO
,rive 1LL' 11Ve VriMHl'1V1V J1'1'L' t
LL #/COLOR TEXTURE
DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
BSERVED WATER TABLE: INCHES [ABOVB/BELOW r] EXISTING GRADE. 'IT PE: [ PERCHED /APPARENT ]
STIMATED WET SEASON WATER TABLE ELEVATION:INCHES .[.ABOVE/BELOW ] EXISTING GRADE
IGH, WATER TABLE VEGETATION: [ ] YES 9� NO MOTTLING: [ ] YES ,[x] NO DEPTH: INCHES
OIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: INCHES
RAINFIELD CONFIGURATION: [ ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
ITE-EVALUATED B �T_ - DATE:
u 4015, 12/11 (ob.oletes previous edition.-hi.h.may not be used) Incorporated: 64E-6.001, FAC Paga 3 0£ 4
oll- 5�
xPPLxLra'i?iOx � APi3889; 1
STATE O$ FILORIDA. JP F�
_ 'fi, F2 _ PERMIT #:56-SF-19't0780
:DEPARTMENT OF HEALTH nocot4ENT c.F►1322f70
ONSITE SEWAGE TREATMENT ANDc 9 10 `- OSAH M SYSTE
CONSTRUCTION IN$PECTION AND FAPPROVAI,L DATE PAID IV2012018----
s-- FEE' PAID-6-1 ram}-00
RECEIPT t:56-PID-3832325
APPLICANT.x.. Bradley 8 Br[ftany Murray,
AGENT: Pace2000.Inc
PROPERTY AnDRassi 4912 Pinetree Dr Fort Pierce, FL34982
LOT: 10.11.8r12 .... - -- 9LOcKs 3....
SOBDIVxSION.I 6dian.River Estates IDIt:- 3402 602A092-000-2'
CHECKED[%I ITEMS ARE NOT IN COMPLIANCE WITH STATUTE: OR ROLE AND MOST RE : CORRECTED..
TANK. INSTALLATION SETEAORS
[ I [:Oil TANK SIZE Ell 1090.00 [21 C 1 [271 SURFACE WATER.. FT
I 3 .[02.3 TANK; MTERIAL Polypropyler[e [ 1 [281 DITCHES 47 FT
[ 1 L031 OUTLET. DEVICE G 3 [291 :PRIVATE WELLS _--_-__ FT
{. 1 [041 MULTI-cBAMBZttEED [i l�-N I - - I I [303 PUBDIC WELLS --__-_ .FT
3 ID53 OUTLET M- THE FolylokPL-68 E. I (31] IFAIGATION WELLS _ .FT
C 1 [061 LEGEND 1., 70-.143-1=4 2, 1. 1' [323 POTABLE WATER75 FT
I [071 WATERTIGHT [ J [331 BUILDING FOUNDATIONS t' FT
� [ 3 (083 LEVEL I 1, [341 PROPERTYLINES26 - FT
G I C091 DEPTH TO LID { ]. 190 OTHER __ _._ FT
DRAINFIELD INSTALLATION FILLED./ MOUND SYSTEM
[. 1 [101 AREA. [l1:_ 384 [21 S4F! [: 1 [36] DRAINFIELD COVER.
] [111 DISTRIBUTION- BOX HEADER. X. [ ].. [371 SHOULDERS
L I E121 NUMBER OF DRAINLINES 1. 4,00 2. [ ] [381 SLOPES
[ I [131 DRAINLINE SEPARATION C I [393 STABILIZATLON 09/20/2019
L I [141 DRAINLINE SLOPE — -
[' 1
Lis]
DEPTH OF COVER
ADDITIONAL. INFORMATION
C 1
1161
ELEVATION [ ABOVE. fEEEIEFS
6.00.
I
1
1463
UNOBSTRUCTED AREA
[ I
[171
SYSTEM LOCATION
[
3'.
[4'i3
STORMHATER RSINOrk
[ ]
[=83
DOSING PUMPS
[
I.
[493
ALARMS'
I I
E1,91
AGGREGATE SIZE
[
]
1431
MAINTENANCE AGREEMENT
I ]
t201
AGGREGATE EXCESSIVE FINES'
E
1'
C443
BUILDING AREA
1'
'(213
AGGREGATE DEPTH
[
].
(451
LOCATION CONFORMS WITH SITE ':PLAN
PILL
/ EXCAVATION MATERIAL.
I
1
1461
FINAL SITE GRADING
3
[221
FILL-AMO➢NT
I
I:.
L473
CONTRACTOR Jeff Nelson (JEFFREY k'NEL
[ 3
[231
FILL: TEXTURE
I
I:
L48I
OTHER INFILTRATOR. QWck4 EQ36 (singles
[ ]
[241
EXCAVATION DEPTH.
ABANDONMENT
E- 1
[251
AREA REPLACED
-I
I
[491
TAN& PUMPED
[' 1
[261
REPT:nr'T'^+F'NT MATERIAL,
[
]
1503
TANK CRUSHED & TILLED
Comments.- Comments are on page 2.
_.._
croNSTROCTxoN [ APPROVED / `` "�`^^ — St. Lucie Cm DATE.- 08/15/2019
DISAPPROVED 3: EnW{o ynental Speclallstll�Ilnq= (ENVIRONMENTAL HEALTH)
tax" SYSTEM L APPROVBD / DISAPPROVED ]:� [ St.LOCIe CHD: DATE: 09f20/2019
Environmental S_pevla0st It an J Ingram :(ENVIRONMENTALHEALTH),
(Explanation of Violations on folloviag.page)
➢H•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 Ap13889j1 EID19i0780
0
STATE Or MRrDA
DWARTfAM& OF Fi=Tk
QNSITR SEWAGE, 4 MATVIEN7 AIM MOOSAL STEM - ,
CONSTRV=w =E=cT'rpK Nip F'TN" APPROVJM
ronnAntc*
ns
Docman;T ji-F11322170
121201201 a,
YZE PAXD:515-00-
Tftp;;is-iTm.—Is sW-d for ibedWoT;svrjfh a-ma)dmpMZcWpwOy of a pepsor%(2 per bedroom),. Cora total estimated flow of'300
NewST. filter, and US long TRENCH DIP installed. No violations, system ok to cover. try phong. Needs final
'Inspection for -mound system, ancl.finaf site grading.
Finpj system apprqV4., Contrictor.atitt bullicIft departmemd"110 anal approval..
DN, 4016.j 00/69 (Obsqletes all pxevi.Ma editions which may not be U404) -
jtjdotpomted'� 64E-6.00S' rAc page 2 ar 3
EH Datab"t �v f.0.1 - AP1330971