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Home My WebLink AboutD O H PAPERWORKRECEIVED §T F MAY 14 1019 e �_S l 4 5iu STATE O A Permitting Department PERMIT NO 510 . DEPARTMENT OF HEALTH St. Luce County DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: '.� SYSTEM RECEIPT #: u lD APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [ ] New System [ ] Existing System [ ] Holding Tank [ ] Innovative I ] Repair [ ] Abandonment [ ] Temporary [ ] NED SGA� vvrnvr�� APPLICANT: GARY DRAKE BY ie County AGENT: ALL COUNTY SEPTIC AND PLUMBING TELEPHONE: 340-4040 MAILING ADDRESS: 4875 BALD CYPRESS TRL FORT PIERCE FL 34951 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: I BLOCK: 2 SUBDIVISION: GREEN ACRES UNIT TWO PLATTED: 1950 PROPERTY ID #: 1430-701-0009-000-9 ZONING: RES I/M OR EQUIVALENT: [ No ] PROPERTY SIZE: .2 ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [/<=2000GPD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: 4912 AMY LN FORT PIERCE FL 34946 DIRECTIONS TO PROPERTY: SEE BUILDING INFORMATION [,(] RESIDENTIAL [ ] COMMERCIAL Unit Type of No. of Building Commercial/Institutional System Design No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC // 1 ob;l2 m9mo .W06a) Iueld? Cons ". 2 3 4 [ ] Floor/EqU pment Drains [ ] Other (Specify) SIGNATURE- DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC DATE: 3n119 Page 1 of 4 RECEIVED STATE OF FLORIDA MAY 14 1019 APPLICATION # AP1410385 DEP NT OF HEALTH ONSITErSEWAGE TREATMENT AND DISPOSAL SYSTithng county PERMIT # SE1164943574 facie County DOCUMENT # SE1164180 SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT- --GaryDrake -- --- -- - — -- - - - -- - - - - - - - -- CONTRACTOR / AGENT: All County Septic LOT: 1 BLOCK: 2 SUBDIVISION: Green Acres ID#:1430-701-0009-000-9 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: 0.20 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 300.00 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: Site BM NID on the comer of Amy & Hammond circled in orange ELEVATION OF PROPOSED SYSTEM SITE 1.00 [ INCHES / FT ] [ ABOVE / BELOW]] 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: FT ' NON -POTABLE: FT BUILDING FOUNDATIONS: $ FT PROPERTY LINES: 18 FT POTABLE WATER LINES: 10 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NOI 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:Nettles sand Munsell #/Color Texture Depth 1 OYR 4/2 Sand 0 TO 9 10YR 4/1 Sand 9 To 20 1 OYR 5/1 Sand 19 To 22 1 OYR 7/1 Sand 22 To 34 1OYR 2/1 Spodic Material 34 To 40 7.5YR 3/3 Spodic Material 40 To 42 7.5YR 3/3 Sand = 42 To 53 7.5YR 4/3 Sand 53 To 64 1 OYR 5/3 Loamy Sand 64 To 72 7.5YR 5/6 CMN/PRM RF 66 To 72 USDA SOIL SERIES:Nettles sand Munsell #/Color Texture Depth 1 OYR 4/1 Sand 0 To 12 10YR 5/1 Sand 12 To 22 1OYR 7/1 Sand 22 To 31 1OYR 2/1 Spodic Material 31 To 52 7.5YR 3/3 Sand 52 To 64 10YR 513 Loamy Sand 64 To 72 7.5YR 5/6 CMN/PRM RF 66 To 72 OBSERVED WATER TABLE: INCHES [ ABOVE / BELOW I EXISTING GRADE TYPE: [ PERCHED / APPARENT I ESTIMATED WET SEASON WATER TA13LE ELEVATION: 20 INCHES [ ABOVE / EE11 EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 20.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: 52 INCHES DRAINFIELD CONFIGURATION• [X_] TRE-NCH _ [_ ] BED [ _] OTHER (SPECIFY)_ REMARKS/ADDITIONAL CRITERIA WSWi determined using USDA WSS and soil borings. 10YR 5/1 stripping in 10YR 411 matrix> 10%with diffuse boundaries starting at 20" in SBI. SB1 1" below ON. SB21" below BM. Topsoil with shell observed in the first 2" of SB2. SITE EVALUATED BY: I20UN DATE: 05I10/2019 oilier, Hunter (Title: Environmental Specialist I) (Florida epartment of Health In St. L DR 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 e AP1410385 EID1943574 v 1.0.2 FDOH in St. Lucie County Environmental Health Site Pla _ Supersed All Previous Site Plans for o 'OSTDS #te• S 5'1+- c7' D e, :i wer: N .-L-< , A a , ISLANDER LINEN MASILR BEDROOM Lum.+ee INWALK W CLOBCE 56' X 28' 2 BR/C 1484 SQ. FT. 2 BATH �e enters �gcEd�O f Too' `�90 .-T LLL.ZLLCLLL_LI_LL DINING YN- LLLLLLLLILL.LLLLLLL !y a _L,LLLI NiQlUI INTORti GREAT ROOM 17'7' BEDROOM #2 DEN IDS' WO' CATHEDRAL CEILING THROUGHOUT -J Homes Designed, Built & Serviced N0DIt.I'1'Y 7p ( ]77T Yam+ �p � �p �'! ►•Inlves I'm BV .L OB Ld d Y.L1®lY E S RUbilileRoincs I'm ./ I MANUPACYURCO 1!I ACCORDANCE WITH STANDARDS DEVELOpCD AV ENFORCED DY HUD. DUD TO OUR CON@RRN PROOMN Or PRDOUCf NPRUYEUEW. PR¢ES AND SPECINCATIONS ARE SMOIECE TO CIIANOC YRIJIUCL NONCE. SOUC ❑CUS SUCH \S RPM, RIMS, AXLES AND INDU6 MAY IMVE O[01 RECYCLE) AMR WSPE000R FOR SUM AND APPRARANCE, ALL DIMENSIONS ARE IIOURIAL m RECS&EO STATE OF FLORIDA MAY 141919 DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSALPefmitting D St. facie CaunQpatyen SYSTEM CONSTRUCTION PERMIT FOR: APPLICANT: Gary Drake OSTDS New PROPERTY ADDRESS: 4912 Amy Ln Fort Pierce, FL 34946 LOT: 1 BLOCK: SUBDIVISION: Green Acres CGI pa-v5 PERMIT #:56-SF-1943574 APPLICATION #:AP1410385 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1225929 PROPERTY ID #: 1430-701-0009-000-9 [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 SPECIFICATIONS T [ 900 ] GALLONS / GPD SeDtic 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 ERS #Pumps [ D [ 375 1 SQUARE FEET Drainfield New SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [x] MOUND [ ] I CONFIGURATION: [u] TRENCH [ ] BED [ N F LOCATION OF BENCHMARK: Site BM NID on the corner Of I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D O T H E R & Hammond circled in orange 1.00 ][ INCHES FT ][ABOVE LBELOW BENCHMARK/REFERENCE POINT 3.00 ][ INCHES FT ][ AHOVE BELOW] BENCHMARK/REFERENCE POINT 1 Vulnru: [ZZ.UU] INCHES EXCAVATION REQUIRED: [ OZ.UU] INCHES system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of gpd. Hunter A Col3ier _ TITLE: Environmental Specialist I APPROVED BY: t xi f Y TITLE: Environmental Specialist I St. Lucie CUD � n A oll�� DATE ISSUED: 05/10/2019 EXPIRATION DATE: 11/10/2020 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 AP1410385 SE1164180 RFCervFL, NOTICE OF RIGHTS MArI4T019 Pe�mitt/q A party whose substantial interest is affected by this order may petition for an St. cu9 °epa tnent administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such c0"Dty 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.