HomeMy WebLinkAboutD O H PAPERWORKMission:
H f ,•,,
> ' t�„ Governor
To protect pxmide & ufpraethe health
of all people inrmiuhnwgh integrated
State, &Woom" "
HEALTH
Vision: To bethe Healthiest State inthe Nation
May 07, 2019
Joshua Clark, Clark Construction
8204 Kenwood Drive
Fort Pierce, FL 34951
RE: Modification to a Single Family Residence - No Bedroom Addition
Application Document Number: AP1411731
Centrax Permit Number: 56-SF-08063
8204 Kenwood Road
Fort Pierce, FL 34951
Lot: 11 Block: 54 Subdivision: Lakewood Park
Dear Applicant,
MAY 0 7 ?(fig
SCANNED
BY
St. Lucie County
This will acknowledge receipt of a floor plan and site plan on 05/0112019 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property.
This office has reviewed and verified the floor plan and site plan you submitted, for the proposed
remodeling addition or modification to your single-family home. Based on the information you provided,
the Health Department concludes:
1. the proposed remodeling addition or modification is not adding a bedroom; and
2. it does not appear to cover any part of the existing system or encroach on the required setback
or unobstructed area.
3. No existing system inspection or evaluation and assessment, or modification, replacement, or
upgrade authorization is required.
Because an inspection or evaluation of the existing septic system was not conducted, the Department
cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use.
You may request a voluntary inspection and assessment of your system from a licensed septic tank
contractor or plumber, or a person certified under section 381.0101, Florida Statutes.
If you have any questions, please call our office at (772) 873-4931.
Sincerely,
44
Brian Ingram
Environmental Specialist II
Department of Health in St. Lucie County
noddy Depvrmmnt of NwNh
. Jiow.h"fflw_
in St Lurie County • 5150 NW Milner Drive • Port Saint Lucie, Florida
TWn7ER:HealthyFLA
34983
PHONE: (772) 873r4931
ACEBOOK:FLDe artmentofHealth
St. 'Lucie County Health Department
HEALTH 5150 NW Milner Dr Port Saint Lucie, FL 34983
PAYING ON: u 56-SF-08063 BILL Docu56-BID-4162842 CONSTRUCTION APPLICATION A AP1411731
RECEIVED FROM: Clark Construction AMOUNT PAID: $ 35.00
PAYMENT' FORM: CHECK 1315 PAYMENT DATE: 05/01/2019
MAIL TO: Tracey Mimms
FACILITY NAME : -Fj2 i
PROPERTY LOCATION:
8204 Kenwood Rd
Fort Pierce, FL 34951
11
Lot:
=CE
Properly ID: 1301-605-0333-00017
EXPLANATION or DESCRIPTION:
139 - OSTDS Application Approval Existing, No Insp
54
Block:
1
QUANTITY FEE
$ 35.00
RECEIVED BY: WhighamJL AUDIT CONTROL NO. 56-PID-3917763
Property Card
o 5'c43
Michelle
Franklin, CFA — Saint Lucie County Property Appraiser — All rights reserved.
Property Identification
Site Address:8204
Parcel ID:1301-605-0333- Account#:1355
See/Town/Range:
KENWOODRD
000-7
02/34S/39E
Map ID: I3/02S
Zoning: RS-4 Use Type: 0100
Jurisdiction: Saint Lucie
County
Ownership
RECEIVED
gal Description
Dale Brown Sr
L
kKEWOOD PARK -UNIT 5- BLK
54 LOTI 1 (MAP 13/02S)
Tracey Mimms
MAY 0 7 2019
8204 Kenwood RD
Fort Pierce, FL 34951
ST, Luele 6eui.ty, Perntltting
Current Values Historical Values 3-year
Just/Market: $143,700 Assessed: $84,845 Year Just/Market Assessed
Exemptions Taxable
Exemptions: $50,500
Taxable: $34,345 2018 $143,700 $84,845
$50,500 $34,345
2017 $132,300 $83,100
$50,500 $32,600
2016 $113,400 $81,391
$50,500 $30,891
Sale History
Date
Book/Page Sale Code Deed Grantor
Price
I I-01-2018
4I98 / 0857 0111 QC Mimms Tracey
$0
11-01-2018
4198 / 0642 0111 QC Mimms Tracey
$100
I1-28-2012
3458 / 1932 0001 WD Winston Philip
$62,000
Primary Building Information
Finished Area of this building: 1,646 SF
Gross Sketched Area: 2,480 SF
View:
Year Built: 2000
Primary Wall: CB Stucco
Bedrooms: 3
Full Baths: 2 '
Half Baths: 0
Roof Cover: Fibrglss Shg
Frame:
Story Height: I Story
A/C %: 100%
Heated %: 100%
Sprinkled %: N/A%
Exterior Data
Roof Structure: Hip
Grade: C
No. Units: I
Interior Data
Electric: MAXIMUM
Heat Type: FrcdHotAir
Heat Fuel: ELEC
Building Type: HC
Effective Year: 2000
Secondary Wall:
Primary Int Wall:
Avg Hgt/Floor. 0
Primary Floors: Carpet
Total Areas
Finished/Under Air
(SF):
Gross Sketched Area
(SF):
Land Size (acres):
Land Size (SF):
Total Building Count
Special Features and Yard Items
Type
Qty Units
Year Blt
UTILITY AVG
1 150
1999
Driv-Concret
1 720
2000
CHAINLINK 6'
1 228
2000
1,646
2,480
0.24
10,480
I
Page 1 of 1
All information is believed to be correct at this time, but is subject to change and is provided without any warranty.
0 Copyright 2019 Saint Lucie County Property Appraiser. All rights reserved.
tttps://www.paslc.org/RECard/
5/1/2019
"r
ra
STATE OF FLORIDA RECEIVED PERMIT NOSY`' OaoLP3
�,.
f DEPARTMENT OF HEALTH µy DATE PAID: I 9
p ONSITE SEWAGE TREATMENT Da,'9�iJ FEE PAID:
SYSTEM RECEIPT #:
APPLICATION FOR CONSTRUC i1b1ku01ER2dfff`p sew v»
APPLICATION FOR:
[ ] New System
[ ] Repair
APPLICANT: C
AGENT: ` IV) I
MAILING ADDRESS:
Existing System [ j ^Holding Tank [I D Innovative .
[ ] Abandonment [ ] Temporary [ ] Ot>
U
TELEPHONE: lIImo-6V-33OZ
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:At BLOCK: _ SUBDIVISION: L AL ( xrd �Llf k PLATTED:
PROPERTY ID #: i301-605-L)333-,P0 ZONING: A-S�� I/M OR EQUIVALENT: [ Y/N ]
PROPERTY SIZE: 01 7-14 ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS
PER 381.0065,
FS? [ Y/N
]
DISTANCE TO SEWER: FT
PROPERTY ADDRESS:
CLOQ
Jz:O"�(I-
fjZlCLf
FL 14S
DIRECTIONS TO PROPERTY:
BUILDING INFORMATION
Unit Type of
No Establishment
1 t,\
2
3
4
a RESIDENTIAL [ ] COMMERCIAL
No. o£, Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
[ ] Floor/Equipment Drains [] Other .(Specify)
SIGNATURE:
DH 4015, 08/09 (O sFiletes previous editions which may not be used)
Incorporated 6-6.001, FAC
DATE: / Z6
Page 1 of 4
/I
STATE OF FLORIDA
DEPART OF HEALTH
:EIME@TE SEWAGE TREATMENT AND DISPOSAL SYSTEM
EXISTING EYSTEM AND SYSTEM REPAIR EVALUATION
g
0 / 2-nu 19
CONTRACTOR / AGENT:
LOT: 1i BLOCK: [t SUBDIV: L l-k !i/'M
PERMIT C: 6---Sr 3
TO BE COMPLETED BY FLORIDA REGISTERED ENGINEER, DEPARTMENT EMPLOYEE, SEPTIC TANK CONTRACTOR OR
OTHER CERTIFIED PERSON. SIGN AND SEAL ALL SUBMITTED DOCUMENTS. COMPLETE ALL APPLICABLE ITEMS.
COMPLETE TANK CERTIFICATION BELOW OR NOTE IN REMARKS WRY THE TANKS CANNOT BE CERTIFIED.
EXISTING TANK INFORMATION
n
GALLONS SEPTIC TANK/GPD ATU
LEGEND:
MATERIAL:['"1' k
BAFFLED4Y / N]
[ ]
GALLONS SEPTIC TANK/GPD ATU
LEGEND:
MATERIAL:
BAFFLED:[Y / NI
[ ]
GALLONS GREASE INTERCEPTOR
LEGEND:
MATERIAL:
[ ]
GALLONS DOSING TANK
LEGEND:
MATERIAL:
PUMPS:[ ]
I CERTIFY THAT THE LISTED TANKS WERE PUMPED ON
{ /'? /i i! BY
'� L)LY��y-]'y-['�/�,k_.1'> HAVE
THE VQLUMES SPECIFIED AS DETERMINED BY [ DIMENSIONS /-rTL�ZIi`J--LEGEND
], ARE FREE OF OBSERVABLE
DE.�99TS OPWLEAKS, AND HAVE A ( SOLIDS DEFLECT%I�ON DEVICE ( OIITL£T
FSLTER DEVIat ] INSTALLED.
SFGNAT 'OF LICENSED CONTRACTOR BUSINESS NAME
DATE
EXISTING DRAINFIELD INFORMATION !'
[ C ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM
NO. OF TRENCHES
[ ] DIMENSIONS: lYl Xl-Y
[ ] SQUARE FEET SYSTEM
NO. OF TRENCHES
[ ] DIMENSIONS: X_.__
TYPE OF SYSTEM: [J'j STANDARD ( ] FILLED [
] MOUND [ ]
CONFIGURATION: [ J TRENCH [ 1 I BED [
]
_
DESIGN: (-] HEADER [ j D-BOX
GRAVITY SYSTEM
[ ] DOSED SYSTEM
ELEVATION OF BOTTOM OF DRAINFIELD IN RELATION TO EXISTING GRADE
INCHES [ ABOVE(/ BELOW)•;
SYSTEM/ FAILURE AND REPAIR INFORMATION
[�j/7 z��t] SYSTEM INSTALLATION DATE
TYPE OF WASTE
[%lJ DOMESTIC [ ] COMMERCIAL
[ •' %+. j GPD ESTIMATED SEWAGE FLOW BASED ON
[ ] METERED WATER [:r;J TABLE 1, 64E-6, FAC
SITE [ j DRAINAGE STRUCTURES [ ] POOL
CONDITIONS: [ J SLOPING PROPERTY [ ]
NATURE OF [ ] HYDRAULIC OVERLOAD
FAILURE: [ 1 DRAINAGE / RUN OFF
FAILURE [ ] SEWAGE ON GROUND
SYMPTOM: ( J PLUMBING BACKUP
[ ] PATIO / DECK [ ] PARKING
[ ] SOILS [ ] MAINTENANCE
[ 3 ROOTS [ ] WATER TABLE
[ ] TANK
[ ] D BOX/HEADER
REMARKS/ADDITIONAL CRITERIA-�k,443' c' ) 1
[ j SYSTEM DAMAGE
[ ]
[ ] DRAINFIELD
,
SUBMITTED BY: i , TITLE/LICENSE j�C, (.%!i [ LO'/t DATE:';:) 1t�,
DR 4015, 08/09 Obsoletes previous editions which may not be used) f
Incorporated 64E-6.001, PAC Page 4 of 4