HomeMy WebLinkAboutD O H PAPERWORKSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR:
APPLICANT: Michael & Melanie
PERMIT #:56-SF-1920120
APPLICATION #:AP1395181
DATE PAID:
FEE PAID:
SCANNED RECEIPT #:
BY DOCUMENT #: PR1201591
St, Lucie County
OSTDS New FILE COPY
Aarshall
PROPERTY ADDRESS: TBD Navion Dr Port Saint Lucie, FL 34987'
LOT: 95 BLOCK: SUBDIVISION: Treasure Coast -Air Park
PROPERTY ID #: 4224-501-0095-000-0 [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 [ 1,200 ] 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 @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 575 ] SQUARE FEET Drainfield new SYSTEM 1
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X] MOUND [ ]
I CONFIGURATION: [X] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: Site BM NiD CL of Rd center of property
I ELEVATION OF PROPOSED SYSTEM SITE [ 16.001['INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 6.00 1C INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D
O
T
H
E
R
r cO.OuJ INCHES EXCAVATION REQUIRED• [ 6 UU ] INCHES
system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of
9pd•
SPECIFICATIONS
BY: Brian J In r
4
TITLE:
Environmental Specialist
II
APPROVED BY:
E: Environmental Specialist II
St. Lucie CHD
Brian J Ingr
DATE ISSUED:
02/06/2019
EXPIRATION DATE:
08/06/2020
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
AP139SIBI SE1151315
NOTICE OF RIGHTS
A party whose substantial interest is affected by1his 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 bylaw, with the Court of Appeal in the
appropriate District Court. The notice must be filed w6.in 30 days of rendition of the final order.
's4 St. Lucie Court Health Department
5150 NW Milner.Dr Port Saint Lucie, FL 34983
HEALTH
PAYING ON: PERMIT* 56-SF-1920120 BILL Doc#56-BID-4072134 CONSTRUCTION APPLICATIONMAP1395181
RECEIVED FROM: Pace 2000, Inc AMOUNT PAID: $ 515.00
PAYMENT FORM: CHECK 6592 PAYMENT DATE: 01/29/2019
MAIL TO: Michael & Melanie Marshall
FACILITY NAME:
PROPERTY LOCATION:
TBD Navion Dr
Port Saint Lucie, FL 34987
95
Lot: Block:
Property ID: 4224-501-0095-000-0
. EXPLANATION or DESCRIPTION:
128 - OSTDS Construction System Inspection Research Fee
-1 - Surcharge (All)
-1 - OSTDS,New Permit Surcharge
-1 - OSTDS Construction Application and Plan Review,New,
123 - OSTDS Construction Site Evaluation
126 - OSTDS Construction Permit (New or Mod, Amendment)
127 - OSTDS Construction System Inspection
133 - OSTDS Construction Reinspection
RECEIVED BY: MontanezNM
QUANTITY FEE
1
$
5.00
1
$
15.00
1
$
100.00
1
$
100.00
1
$
115.00
1
$
55.00
1
$
75.00
1
$
50.00
AUDIT CONTROL NO. 56-PID-3850827
• I
_ Ah STATE Or MORIDA
J}
liDEPARTMENT or HEALTH
i TONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
'on we1`� '
"�••�' APPLICATIONFOR CONSTRIICTION PERMIT
APP4T1-`ATION FOR:
IeA New System [ ] Existing system
[ 7 Repair [ ] Abandonment
APPLICANT:X
AGENT: A
MAILING ADDRESS:
well No. 9aglb
r5-ilu
PERMIT N0. SAC; �F 9� {�
DATE PAID:
FEE PAID: -cI. is
RECEIPT 1h _ li0P�1
[ ] Holding Tank [. ] Innovative
[ ] Temporary [ ]
TELEPHONE : t % 7-
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 DOCUMCNTATION OF THE DATE THE LOT WAS CREATED OR
PLATTED (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS.
PROPERTY INFORMATION LOT: C- BLOCK: ON zu 1�t7/7J�'%/Qow PLATTED: /98ff
PROPERTY ID 41; 42M-�r7)1-(JlJ`1!1-c�,.L�-aONING: I/M OR EQUIVALENT: [ Y / N ]
PROPERTY SIZE: ACRES WATER SUPPLY: [PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y / D ] � "� DISTANCE TO SEWER: FT
PROPERTY ADDRESS: c
DIRECTIONS TO PROPERTY:
BUILDING INFORMATION
Unit Type of
No .Establishment
2
3
4
SIGNATURE:
R
,
RESIDENTIAL [ ] COMMCRCIAL
No. of Building Commercial/Institttional System Design
Bedrooms Area 9q£b Table 1, Chapter 64E-6 FAC
[ ] Other (Spscifjr)!
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC
DATE: A I I /.1- I d cl. _- -
Page 1 of 4
STATE OF FLORIDA APPLICATION # AP1395181
DEPARTMENT OF HEALTH PERMIT # 56-SF-1920120
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1151315
APPLICANT: Michael & Melanie Marshall
CONTRACTOR / AGENT.:. Pace 2000,Inc
LOT: 95 BLOCK:
SUBDIVISION: Treasure Coast Air Park 'ID#:4224-501=0095-000-0
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: EX ]YES [ ]NO NET USABLE AREA AVAILABLE: 4.96 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 460 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 7440.01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1600.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1150.00 SQFT
BENCHMARK/REFERENCE POINT LOCATxON: Site BM Nib CLof Rd center of property
ELEVATION OF PROPOSED SYSTEM SITE 16.00 [ INCHES / FT ] [ ABOVE /
BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: 100 FT
DITCHES/SWALES:, 100_ FT
NORMALLY WET: [ ]YES
[X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE:
100 FT NON -POTABLE:
FT
BUILDING FOUNDATIONS: 5 FT
PROPERTY�LINES: 37 FT
POTABLE WATER LINES:
80 FT
SITE SUBJECT TO FREQUENT FLOODING?
[ ]YES ['X I-Nd
10 YEAR FLOODING? [ ]YES
[X]N OJ
10 YEAR FLOOD ELEVATION FOR SITE:
FT [ MSL / NGVD I- SITE ELEVATION: FT [ MSL
/ NGVD
SOIL PROFILE INFORMATION SITE 1
i
SOTL PROFILE..
TNEORMATTON STTR 9
USDA SOIL SERIES:Wabasso sand
Munsell #/Color Texture
Depth
1 OYR 3/1
Loamy Sand
0 To 6
1 OYR 4/2
Sand
6 To 26
1 OYR 5/1
Sand
14 To 48
7.5YR 4/6
PEAT
48 To 53
1 OYR 6/4
Sand
53 To 64
HOLE CAVING
Refusal
64 To 72
USDA SOIL SERIES:Wabasso sand
Munsell #/Color Texture
Depth
10YR 312
Loamy Sand
0 To 4
1 OYR 413
Sand
4 To 27
1 OYR 5/2
Sand
16 To 46
7.5YR 4/6
PEAT
46 To 55
1 OYR 5/2
Loamy Sand
55 To 65
HOLE CAVING
Refusal
65 To 72
OBSERVED WATER TABLE: 27.00 INCHES [ ABOVE ./ ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 14 INCHES [ ABOVE / EEI EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES EX ]NO MOTTLING: [X]YES [ ]NO DEPTH: 14.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 'DEPTH OF EXCAVATION: 6 INCHES
DRAINFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
- REMARKS/ADDITIONAL CRITERIA
WSWT determined using USDA WSS and soli borings. .
10YR511 stripping in 10YR4/2 matrix >10% with diffuse boundaries starting at 14" In S81.
581 16" below BM. SB2 15" below BM.
SITE EVALUATED BY:
Ingram, Brian (Tit . Environmental Specialist II) (ENVIRONMENTAL HEALTH)
DH 4015, 08/09 (Obsoletes previous aditiona whi h may not be used) Incorporated: 64E-6.001, FAC
DATE: 02/04/2019
Page 3 of 4
AP1395181 EID1920120
v 1.0.2
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
..,/7
APPLICANT:n' 4��� 1L1�� ouldfndWj'iL
„GOT: j BLOCK; SUBD7
PROPERTY ID 4k;�a��... �) (._(��t) _o [Section(Townslup/Parcel No. or Tax ID Number
PERMIT 4t. 56-5, - r /2G120
57? - 15
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS
%isl 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: i� b ACRES
TOTAL ESTIMATED SEWAGE FLOW: _ �� O GALLONS PER DAY [RESIDENCES -TABLE I/OTIff-R-TABLE2 ]
AUTHORIZED SEWAGE E'LOW: GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
JNOASTRUCTED AREA AVAILABLE: n (] SQFT UNOBSTRUCTED AREA'REQUIRED: Q C7 SQFT
BENCHMARK/REFERENCE POINT LOCATION:'
ELEVATION OF PROPOSED SYSTEM SITE ISV [y)).).gpS/FT.,]. [ABOVE/BE 7 HENCHMARIC�/REFERENCE POINT
THE MSIT]]OM SETBACK WHICH CAN BE MAINTAINED FROM'THE PROPOSED SYSTEM TO THE FOLLOWING FEATURE'S
SURFACE WATPUBLIC:
O FT DITCHES/SWALES: �,j'_Q. FT NORSIALLY WET? [ ] YES f NO
iiELLS: PUBLIC: �j�_- { „ .
O FT LIFTED USE: ZQ Ci E'T PRIVATE: `�J FT NON -POTABLE: � FT
BUILDING FOUNDATIONS: __ZQ_L FT PROPERTY LINES:L:!!�,;Q FT POTABLE WATER LINES: FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [14�NO 10 YEAR FLOODING? [ ] YES ]✓]'NO
10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD
MUNSELL 1]/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
JU" rxvr'iLli 1i41Nul_(mwX'l(JN SITE L
MUDTSELL #/COLOR TEXTURE DEPTH
TO
USDA SOIL SERIES:
TO
TO
TO
0419,
OBSERVED WATER TABLE; INCHES [ABOVE/BELOW.' r] EXISTING GRADE. TYPE: [ PERCHED /APPARENT ]
1STIMATED NET SEASON T•�TER TABLE ELEVATIO INC S [. ADOVE/BELOW ] EXISTING GRADE
SIGH WATER TABLE VEGETATION: [ ] YES [�D MOTTLING: [ ] YES [ ] NO DEPTH: INCHES
SOIL.TEXTURE/LOADING RATE FOR SYSTEM SIZING:
"ORASNF,LELD CONFIGURATION: [ I TRENCH [ ] BED
2EMAR1. /ADDITIONAL CRITERIA:
SITE EVALUATED
DEPTH OF EXCAVATION:
] OTHER (SPECIFY)
INCHES
JH 40151 12/11 (Obsolete. Previous editions which may not be used) Incorporated: 64E-6.001, FAC / 'age 3 Of 4
Property Card Page 1 of 1
5615F-19Z.o1Zv 51- L-IIve
Michelle Franklin, CFA -- Saint Lucie County Properly Appraiser -- All rights reserved.
Property Identification
Site Address: NAVION DR Parcel ID: 4224-501-0095- Account #: 125856 Sec/Town/Range:
000-0 24/37S/38E
Map ID: 42/23X Zoning: AG-5 Use Type: 0000 Jurisdiction: Saint Lucie
County
Ownership Legal Description
Michael P Marshall
TREASURE COAST AIRPARK LOT 95 (4.96 AC) (OR 3654-
Mclanie A Marshall
2557)
4525 SW 55th Ave
Davie, FL 33314
Current Values
Historical Values 3-year
Just/Market: $103,400 Assessed:
$103,400 Year 'Just/Market
Assessed Exemptions
Taxable
Exemptions: $0 Taxable:
$103,400 2018 $103.400
$103,400 $0
$103,400
•
2017 $104,200
$104,200 $0
$104,200
2016 $104,200
$104,200 $0
$104,200
Date
07-18-2014
I1-01-2005
05-27-2003
View:
Year Built: N/A
Primary Wall:
Bedrooms: 0
Full Baths: 0
Half Baths: 0
Book/Page
3654/2557
2405/2641
1721/2849
Roof Cover:
Frame:
Story Height
Sale.History
Sale Code Deed Grantor
0001 WD Caro Nicolas A
XX00 WD Three Bad Dogs Inc
XX00 WD McCarty III Daniel T
Primary Building Information
Finished Area of thisbuilding: 0 SF
Gross Area of this building: 0 SF
Exterior Data
Roof Structure:
Grade:
No. Units: 0
Interior Data
Price
$95,000
$215,000
$120,000
Building Type:
Effective Year: 2014
Secondary Wall:
A/C %: 0% _ Electric: Primary Int Wall:
Heated %: N/A% Heat Type: Avg Hgt/Floor: 0
Sprinkled %: 0% Heat Fuel: Primary Floors:
Total Areas
' - Finished/Under Air 0
c (SF):
Gross Area (SF): 0
Land Size (acres): 4.96
Land Size (SF): 216,057.E
Total Building Count 1
Special Features and Yard Items
Type Qty Units Year Blt
This information is believed to be correct at this time but it is subject to change and is not warranted.
® Copyright 2019 Saint Lucie County Property Appraiser. All rights reserved.
0
ittps://www.pasle.org/RECard/ 1/29/2019
1 r g NG\,J1U.n,
z W4Yf
Custom Soil Resource Report
Soil Map 5(�_Sr k
qgR��
6,4.60 Sa9410 5f�0 G�010 �v5ffif0 �
3 .g
MaPSole: 1:916fiPvtWwAPwbat(8.4'x11yd�t.
N Z0 40 t0 o W
A o 40 w z�
MUP Pm)eQiq,: Web Mercer Qa wardnats: WGS84 Edge 86: U,M Zm 17N WGS84
6
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Custom Soil Resource Report
St. Lucie County, Florida
48—Wabasso sand, 0 to 2 percent slopes
Map Unit Setting
National map unit symbol. 2svyr..
Elevation: 0 to 70 feet
Mean annual precipitation: 46 to 55 inches
Mean annual air temperature: 70 to 77 degrees F
Frost -free period: 355 to 365 days
Farmland classification: Farmland of unique importance
Map Unit Composition
Wabasso and similar soils: 85 percent
Minor components: 15 percent
Estimates are based on observations, descriptions, and transects of the mapunit.
Description of Wabasso
Setting
Landform: Flatwoods on maririe4erraces
Landform position (three-dimensional): Tread, tall
Down -slope shape: Linear' -
Across -slope shape: Linear
Parent material: Sandy and loamy marine deposits
Typical profile
A - 0 to 6 inches: sand
E - 6 to 25 inches: sand
Bh - 25 to 30 inches: sand
Btg - 30 to 58 inches: sandy clay loam
Cg - 58 to 80 inches: loamy sand
Properties and qualities
Slope: 0 to 2 percent
Depth to restrictive feature:.9 to 50 inches to strongly contrasting textural
stratification t -
Natural drainage class: Poorly drained
Runoff class: Very high
Capacity of the most limiting layer to transmit water (Ksat): Moderately low to
moderately high (0.06 to 0;20 in/hr)
Depth to water table: About 6 to 98 inches
Frequency of flooding: None
Frequencyofponding: None
Calcium carbonate, maximum in,profile: 5 percent
Salinity, maximum in profile:;, Nonsaline to very slightly saline (0.0 to 2.0
mmhos/cm)
Sodium adsorption ratio, maximum in profile: 4.0
Available water storage in profile: Very low (about 1.4 inches)
Interpretive groups
Land capability classification (irrigated): None specified
Land capability classification (nonirrigated): 3w
Hydrologic Soil Group: C/D
10
Custom Soil Resource Report
Forage suitability group;..Sandy soils on flats of mesic or hydre lowlands
(G155XB141FL)
Other vegetative classification: South Florida Flatwoods (13155XY003FL:
Hydric soil rating: No
Minor Components
Hallandale
Percent of map unit: 6 percent
Landform: Flatwoods on marine terraces
Landform position (three-dimensional): Tread, tall
Down -slope shape: Linear
Across -slope shape: Linear
Other vegetative classification: South Florida Flatwoods (R155XY003FL)
Hydric soil rating: Yes
Boca
Percent of map unit: 5 porceni_ _.
Landform: Drainageways on marine terraces, flats on marine terraces
Landform position (three-dimensional): Tread, dip, talf
Down -slope shape: Linear,.convex
Across -slope shape: Linear, concave
Ecological site: South Florida Flatwoods (R155XY003FL)
Other vegetative classification: South'Florida Flatwoods (R155XY003FL)
Hydric soil rating: Yes
Pineda
Percent of map unit: 4 percent
Landform: Drainageways on marine terraces, flats on marine terraces
Landform position (three-dimensional): Tread, dip, talf
Down -slope shape: Linear
Across -slope shape: Concave, linear
Othervegetative classification: Slough (R155XY011FL)
Hydric soil rating. Yes
W
s„! '. r Yam&' t nk ` i'r"(. ° ♦ {*� 9 a .
GI��-.j
sE. •; '` r *�� s'f'b :..wry{ 0.� R398ti 0.-eC7�11
1 ry' II�p � Jr $
V�.v.. '^ x � ♦ r.�lah��p C.,.y '°ki F '.tom`
t e SS##
Mission:
To protect, promote & improve the health
of all people in Florida through integrated
state, county & community efforts.
1 (.
HEALTH
Vision: To be the Healthiest State in the Nation
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
SCANNED
BY
Effective July 24, 2017 St. Lucie County
• 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-WELLSna FLHEALTH.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()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 Lucie County • Division of Disease Control and Health Protection
Bureau of Environmental Health
5150 NW Milner Drive
Pod St Lucie, FL 34983 Accredited Health Department
PHONE: 772/873-4931 • FAX: 772/895-1306 ' = Public Health Accreditation Board
FloridaHealth.gov
STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT,
REPAIR, MODIFY, OR ABANDON A WELL
❑Northwest PLEASE FILL OUT ALL AWL'ICAeLE FIELDS
C1StJohnst ('Denotes Required Relds'WhoreApplicable)
St. Johns River
4CSouthFlorida rhewatarrvell<onrrarrorf epodtblefoleampleWv
�S.uwannee River this 10f(ha dlbnvxdin9rhep¢1nJinppG[ab'on fortis
13DEP OPPIOPrtafcdeleIIittedandiorltywl(ere,npplimbla
❑ Delegated Authority (If Applicable)
59-291
Stipulations Required (Sea -Attached)
Delineallon No.
• • avv-nuaress; rroap-Name or Number. Cl
3.4224+501-0095-000-D
'
Parcel ID No. (PIN) orAltern`ate;Key (Chcle'One) - 95
4.24 37S 38E St Lucie Lot Block Unit
'Sectioneso Land ullvsrant "TOwnsli(p •Rorie . Check if 2-524:❑' Yes.Or,No
5 Jarnes ell-uTyson 9 •Ll -11 Numbenty subd;vlsroo
11352 954c818,4269 downthehoie@att.net
"Water WeI6Contrdctor
s,PO:BOX.881496. r "Telephone Number E mall Address
' law I i ell i ont[actor's gddress Port St.. Lucie FI 34988.,.
7 -TypeoflNorjc COnStrUallofl City - State - ZIP'
[� Repair Modificatlon0 Abandonment
8 'Number:of.Aroposed�lNells 'I
9 SpeGfy Inlendeil UseW i` UVell(s); 'Reason arRepa ,
Domestic Landscape Irrigation '
f ir. Mo� onAtian men!
tlon
Bottled Water Supply ® Recreation Ares-Intgallon e o e Agricultural Irrigation 8 Site Investigations
Public Water Supply Limited:Use/OOH �- Livestock Monitoring
PP y ( ) ❑ NurseryIrrigation Test Public Water Supply (COmmUnity'or El
COmmarclaUlntlusrrfal 'FEB 6 2019
Classl in)ec6pn Earth-CeupieU Geothermal
Golf Course Irrigation .. HVAO Supply
Class VInjection: ❑ Recharge ❑ CommerUel)Industdal Disposal HVAC Return
RemedlatlOn: Rewve P ❑ Aquifer Storage�and Recovery ❑ Drainage OH in St Lude Count,
❑ ry❑..Alr Sparge ❑ etim r (Desorite)
❑ Other (Oeavieu) IROWENTakjEALI
10.'Dlstance from Septic Systemif 5200ft '1L Facillty,Descnpgon` �.es1 once
13.'Estimated.Well-Depth Pft, •Estimeled Ce'sih Depth d 12+ Estimated Stai4 Date
9 Pil Primary. OasingDiameter . 2. In. Open Hole:. From=Tc_fL
14. EsUmated.Screen Interval. From._ To� g,
1 S.'PdmaryCasing Material: Black Steel Galvanized
•Not Cased Other.,NG VC F Stainless Steel
16.Secondary Casing: Telescope Casing .Uiler Surface Casing Diameter in.
17. Secondary Casing' Material: Black Steel Galvanized PVC Stainless Steel Other
18.'Method 0f COnStructlon, Repair, or Abandonment: Auger Cable Tool �th
GernbmaUon (Two or More'Methods Jelled Sonic
Hand Driven (WellPoinf,'Sand Polm) Hydraulic Polnl (DIreU Push)
HorizontatDrillin9 Plugged by Approved Method Other (Dosulha)
19. Proposed Grouting Interval for the Primary, Sgcoridkry, and A WditeTCas
From 737a � Seel Material ( Ben(oriita.',"
Frbm Seal Material ( Bemonite 'Neat Cement Other_ 1 `
From To. Other_ )
SPatMitartal ( .Bemonite Neat Getnenf Other . 1. From To Seal Material{ t3entohile Neat Cement Other. )
20. Indicate total number of existing --wells on site -
or CUPANUPA "Dragon 9 as, co r of existing unusedtwelis an site O.
P Lon !t mplete the fogowProperN,covered under a ConsumptivelWater,:Use Permit (CUPMIUP):
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P Ui Yes
22. Latitude Pg: C / MP Na ' DislrictWell ID "No
23. Dale.Obtalned From: GPS Man
Fee Received S
Receipt No Check No. _
THIS PERMIT IS NOT VALID UNTIL PROPERLY' SIGNED BY -AN AUTHORIZED OFFICER REPRESENTATIVE OF THE WMD
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Page 1 of 1
Michelle Franklin, CFA -- Saint Lucie County,, Property Appraiser — All rights reserved.
Property Identification
Site Address: NAVION DR Parcel ID: 4224-501-0095- , Account #: 125856 Sec/rown/Range:
000-0 24/37S/38E
Map ID: 4223X Zoning: AG-5 Use Type: 0000 Jurisdiction: Saint Lucie
County
Ownership Legal Description
Michael P Marshall TREASURE COAST AIRPARK LOT 95 (4.96 AC) (OR 3654-
Mclanie A Marshall 2557)
4525 SW 55th Ave
Davie, FL 33314
Current Values Historical Values 3-year
Just/Market: $103,400 Assessed: $103,400 Year
Just/Market
Assessed
Exemptions
Taxable
Exemptions: $0 Taxable: $103,400 2018
$103,400
$103,400
$0
$103,400
2017
$104,200
$104,200
$0
$104,200
2016
$104,260
$104,200
$0
$104,200
Date
07-18-2014
II-01-2005
05-27-2003
View:
Year Built: N/A
Primary Wall:
Bedrooms: 0
Full Baths: 0
Half Baths: 0
Sale History
Book/Page
Sale Code Deed -_ Grantor
3654 /2557
0001 WD Caro Nicolas A
2405 / 2641
XX00 WD Three Bad Dogs Inc
1721 / 2849
XX00 WD McCarty III Daniel T
Primary Building Information
Finished Area of this building: 0 SF
Gross Area of this building: 0 SF
Exterior Data
Type
Price
$95,000
$215,000
$120,000
Roof Cover:
Roof Structure:
Building Type:
Frame:
Grade:
Effective Year: 2014
Story Height:
No. Units: 0
Secondary Wall:
Interior Data
A/C %: 0%
Electric:
Primary Int Wall:
Heated %: N/A%
Heat Type:
Avg Hgt/Floor: 0
Sprinkled %: 0%
Heaf One]:
Primary Floors:
Total Areas
..
-
Finished/UnderAir 0
(SF):
Gross Area (SF): 0
Land Size (acres): 4.96
Land Size (SF): 216,057.6
Total Building Count: 1
Special Features and Yard Items
Qty .Units Year Bit
This information is believed to be correct at this time but it is subject to change and is not warranted.
® Copyright 2019 Saint Lucie County Property Appraiser. All rights reserved.
ittDs://www.Daslc.or2/RECard/ 2/6/2019