HomeMy WebLinkAboutD O H PAPERWORK, -I
STATE OF FLORIDA
DEPARTMENT OF HEALTH L'
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM SCANNED
BY
St. Lucie County
CONSTRUCTION PERMIT FOR:
APPLICANT: Ben Gotti
OSTDS New
PROPERTY ADDRESS: 4600 Grady Dr Fort Pierce, FL 34946
PERMIT #:56-SF-1692824
APPLICATION #:AP1332832
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1098811
LOT: 5,6&7 BLOCK: P SUBDIVISION: Harmony Heights
PROPERTY ID #: 1431-701-0280-000-5 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE A SPECIF
ICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 64E-6, F.A,C. )� TDES NOT GUARANTEE
SATISFACTORY 'PERFORMANCE FOR ANY SPECIFIC PE ~ODi I ERIALFACTS,
WHICH SERVED AS A HASIS FOR ISSOANCE OF TS REMODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT E 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
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS'GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY I ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
D [ ,375 ] SQUARE FEET
R [ ] SQUARE FEET
A TYPE SYSTEM: [X]
I CONFIGURATION: [X]
N
F LOCATION OF BENCHMARK:
Drainfield new SYSTEM
N/A SYSTEM
STANDARD [ ] FILLED [I MOUND [ ]
TRENCH [ ] BED [ ]
BM FND 5/8" IRC
I ELEVATION OF PROPOSED SYSTEM SITE
E,BOTTOM OF DRAINFIELD TO BE
L
D
0
T
H
E
R
ELEV 24.35'
[ 41.00 1 [1 INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
[ 58.001[ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
acyvaa�s,u: r 1.UV i 1NCHE5 EXCAVATION REQUIRED: [ 35.UU ] INCHES
The system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of
300 gpd. .0
The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with
s. 64E-6.013(3)(f), FAC.
SPECIFICATIONS
BY: Brian J Ingr
TITLE: Environmental Specialist
II
APPROVED BY:
TITLE: Environmental Specialist II Re.
St. Lucie CAD
Brian J Ingram
DATE ISSUED:
03/21/2018
EXPIRATION DATE:
9vl/2019
DR 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 AP3332832 SE1069395
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
5150 NW Milner Dr Port Saint Lucie, FL 34983
PAYING ON: PBRMITrt56-SF-1692824 BILL DOC #:56-BID-3683634 CONSTRUCTION APPLICATION #: AP1332832
RECEIVED FROM: Ben Gotti AMOUNT PAID: $ 390.00
PAYMENT FORM: CASH PAYMENT DATE: 03/09/2018
MAIL TO: Ben Gottl
FACILITY NAME:
PROPERTY LOCATION:
4600 Grady or
Fort Pierce, FL 34946
Lot: 5,6&7 Block: P
Property ID: 1431-701-0280-000-5
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)
QUANTITY FEE
1 $
5.00
1 $
15.00
1 $
100.00
1 $
100.00
1 $
115.00
1 $
55.00
RECEIVED BY: WhighamJL AUDIT CONTROL NO. 56-PID-3494550 _
�y
o
HEALTH
PAYING ON:
RECEIVED FROM:
PAYMENT FORM:
MAIL TO: Ben Gotti
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
PERMITM 56-SF-1692824 BILL ooc#:56-BID-3135188 CONSTRUCTION APPLICATIONM AP1246673
Arnold Surveying, Inc. AMOUNT PAID: $ 515.00
CREDIT CARD PAYMENT DATE: 07/01/2016
FACILITY NAME:
PROPERTY LOCATION:
4500 Grady Dr
Fort Pierce, FL 34946
Lot: 5,6&7
Property ID:
1431-701-0280-000-5
EXPLANATION or DESCRIPTION:
Block: P
QUANTITY
-1 - OSTDS Construction Application and Plan Review,New
1 $
123 - OSTDS Construction Site Evaluation
1 $
126 - OSTDS Construction Permit (New or Mod, Amendment)
1 $
127 - OSTDS Construction System Inspection —
1 $
128 - OSTDS Construction System Inspection Research Fee
1 $
133 - OSTDS Construction Reinspection —
1 $
-1 - Surcharge (All)
1 $
-1 - OSTDS New Permit Surcharge
1 $
RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-2996915
FEE
100.00
115.00
55.00
75.00
5.00
50.00
15.00--
100.00 —
MP
4 STATE OF FLORIDA
DEPARTMENT OF HEALTH
p ONSITE SEWAGE TREATMENT AND DISPOSAL
a�w SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
PERMIT NO.
DATE PAID: --��—
FEE PAID:
RECEIPT #:
APPLICATION FOR:
{fj New System C ] Existing System [ ] Holding Tank [ ]
[ ] Repair [ ] Abandonment [ ] Temporary [ ]
Innovative
APPLICANT: ,(3 e/Ypp(Tov / /r U/r7 )' y/5' -a9'�- 36519'
AGENT: 2J / Z TELEPHONE: y/'sue 02 9�" JS %2,
MAILING ATlDRESS: • to
ea=eve====_ae.=aaa=a.ava�===ava=evaavcvaavicevvvicevvavvv=ac:vavevvvn vv _cav_pavgvv�epagcaPa
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 $OCIIMENTATION OP THE DATE THE LOT WAS CREATED OR
PLATTED (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS.
PROPERTY INFORMATION
BLOCK: to SUBDIVISION: 11,7P I o v y /%e�5�/� J?/I:7 `i'iu/`/ PLATTED: '7S
PROPERTY ID #: - OOp -S ZONING: k,S -y - I/M OR EQUIVALENT: [ ye ]
PROPERTY SIZE 6.5� ACRES WATER SUPPLY: C ] PRIVATE PUBLIC r11<=20004UPD { 3>20 0 OGPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y/0 ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: IGoa &-A�a X OP i ✓ e- /20/% f /P�<< /A4- 3 & V<;
DIRECTIONS TO PROPERTY:
BUILDING INFORMATION
Unit Type of
No Establishment
2
3
4
[ ] RESIDENTIAL •[ I COMMERCIAL
No, of Building Commercial/Institutional System Design
Bedrooms Ar/e2a �Sggft Table 1t Chapter 64E-6, PAC
C ] Floor/Equipment Drains C I Other (Specify)
SIGNATURE:
DATE:
bH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6-001, PAC Page 1 of 4
STATE OF FLORIDA APPLICATION # AP1332832
DEPARTMENT OF HEALTH PERMIT # 56-SF-1692824
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1069395
APPLICANT: Ben Gotti
,CONTRACTOR / AGENT: Ben GOtti
LOT: 55.6&7 BLOCK: P
SUBDIVISION: Harmony Heights ID#:1431-701-0280-000-5
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: 0.86 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES -TAB LEI / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 2150.02 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 627.00 SQFT UNOBSTRUCTED AREA REQUIRED: 563.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION:
ELEVATION OF PROPOSED SYSTEM SITE
BM FND 5/8" IRC
41 nn rFINCR
ELEV 24.35'
FT ] [ ABOVE /I BELOW I] 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: PT LIMITED USE: FT PRIVATE:
FT NON -POTABLE:
75 FT
BUILDING FOUNDATIONS: 5 FT
PROPERTY LINES: 40 FT
POTABLE WATER LINES:
10 FT
SITE SUBJECT TO FREQUENT FLOODING?
[ ]YES [X]ND 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:Oldsmar sand
Munsell #/Color Texture
Depth
1 OYR 311
Fine Sand
0 To 12
1 OYR 512
Sand
12 To 25
10YR 4/1
Sandy Clay Loam
25 To 29
1 OYR 4/1
Sand
29 To 36
1 OYR 5/2
Sand
36 To 40
1 OYR 6/2
Sand
40 To 59
1OYR 5/8
CMN/PRM RF
41 To 59
10YR 312
Sand
59 To 63
1 OYR 3/4
Sand
63 To 72
USDA SOIL SERIES:OIdsmar sand
Munsell #/Color Texture
Depth
10YR 3/1
Fine Sand
0 To 16
10YR 612
Fine Sand
16 To 27
1 OYR 5/2
Sandy Clay Loam
27 To 35
1 OYR 4/1
Sand
35 To 41
10YR 512
Sand
41 To 46
10YR 6/2
Sand
46 To 65
10YR 5/8
CMN/PRM RF
48 To 64
1OYR 3/3
Sand
65 To 72
OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 41 INCHES I ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 41.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: 35 INCHES
DRAINFIELD CONFIGURATION: [X] TRENCH [ ] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA
10YR5/8 CMN PROM RF mottling in 10YR6/2 matrix >2% starting at 41" In SB1.
SB1 41" below SM. SB2 36" belo SM.
SITE EVALUATED BY: DATE: 03/14/2018
Ingram, Brian (Title: En nmental Specialist 11) (ENVIRONMENTAL HEALTH)
DR 4015, 08/09 (Ohsoletes previous editions which ma not he used) Incorporated: 64e-6.001, FAC Page 3 of 4
AP1332832 EID1692824 V 1.0.2
'roperty Card
5(0 -
SF- f (p 9 ZY Zy Pagel of]
Site Address: 4600 GRADY
Parcel ID: 1431-701-0280- Account #: 10571
Sec/Town/Range:
DR
000-5
31/34S/40E
Map 1D: 14/31S
Zoning: RS-4
Use Type: 0000
Jurisdiction: Saint Lucie
County
Ownership
Legal Description
Monica M Arguello
HARMONY HEIGHTS ADDN BLK P LOTS 5,6 AND 7 (OR
1285 Baring BLVD # 313
3658-1561; 3714-1574)
Sparks, NV 89434
Current Values
Historical Values
3-year
Just/Market: $10,500
Assessed: $10,500
Year Just/Market Assessed
Exemptions Taxable
Exemptions: $0
Taxable: $10,500
2015 $10,500 $10,500
$0 $10,500
2014 $10,500 $10,500
$0 $10,500
2013 $10,500 $10,500
$0 $10,500
Date
01-13-2015
07-25-2014
11-01-2012
View:
Year Built: N/A
Primary Wall:
Bedrooms: 0
Full Baths: 0
Half Baths: 0
Sale History
Book/Page
Sale Code Deed Grantor
3714 / 1574
0130 WD Monica Tax Services LLC
3658 / 1561
0001 WD Gratia Group LLC,
3504 / 2055
0111 QC Asset Quest LLC,
Primary Building Information
Finished Area of this building: 0 SF
Gross Area of this building: 0 SF
Exterior Data
Type
Roof Cover:
Roof Structure:
Frame:
Grade:
Story Height:
No. Units: 0
Interior Data
A/C %: 0%
Electric:
Heated %: N/A%
Heat Type:
Sprinkled %: 0%
Heat Fuel:
Total Areas
Price
$100
$6,900
$0
Building Type:
Effective Year: 2014
Secondary Wall:
Primary Int Wall:
Avg Hgt/Floor: 0
Primary Floors:
Finished/Under Air
0
(SF):
Gross Area (SF):
0
Land Size (acres):
0.86
• Land Size (SF):
37,440
Total Building Count:
1
Special Features and Yard Items
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 2016 Saint Lucie County Property Appraiser. All rights reserved.
-V�l M1.1
S S 0 HQOD gn-.v ffn3 VDO WMON @t MU @Cmb.
Custom Soil Resource Report
Map Unit Legend
Map Unit Symbol
Map Unit Name
Acres in A01
Percent of AOI
5
Arents, 45 to 65 percent slopes
0.4
13.4%
25
Nettles and Oldsmar sands
2.7
81.1%
99
Water
0.2
5.5%
Totals for Area of Interest
3.3
100.0%
Map Unit Descriptions
The map units delineated on the detailed soil maps in a soil survey represent the
soils or miscellaneous areas in the survey area. The map unit descriptions, along
with the maps, can be used to determine the composition and properties of a unit.
A map unit delineation on a soil map represents an area dominated by one or more
major kinds of soil or miscellaneous areas. A map unit is identified and named
according to the taxonomic classification of the dominant soils. Within a taxonomic
class there are precisely defined limits for the properties of the soils. On the
landscape, however, the soils are natural phenomena, and they have the
characteristic variability of all natural phenomena. Thus, the range of some
observed properties may extend beyond the limits defined for a taxonomic class.
Areas of soils of a single taxonomic class rarely, if ever, can be mapped without
including areas of other taxonomic classes. Consequently, every map unit is made
up of the soils or miscellaneous areas for which it is named and some minor
components that belong to taxonomic classes other than those of the major soils.
Most minor soils have properties similar to those of the dominant soil or soils in the
map unit, and thus they do not affect use and management. These are called
noncontrasting, or similar, components. They may or may not be mentioned in a
particular map unit description. Other minor components, however, have properties
and behavioral characteristics divergent enough to affect use or to require different
management. These are called contrasting, or dissimilar, components. They
generally are in small areas and could not be mapped separately because of the
scale used. Some small areas of strongly contrasting soils or miscellaneous areas
are identified by a special symbol on the maps. If included in the database for a
given area, the contrasting minor components are identified in the map unit.
descriptions along with some characteristics of each. A few areas of minor
components may not have been observed, and consequently they are not
mentioned in the descriptions, especially where the pattern was so complex that it
was impractical to make enough observations to identify all the soils and
miscellaneous areas on the landscape.
The presence of minor components in a map unit in no way diminishes the
usefulness or accuracy of the data. The objective of mapping is not to delineate
taXGAQI^i^ classes but rather to separate the landscape into Ianrifnrmc nr _
landform segments that have similar use and management requirements. The
delineation of such segments on the map provides sufficient information for the
development of resource plans. If intensive use of small areas is planned, however,
Custom Soil Resource Report
St. Lucie County, Florida
5—Arents, 45 to 65 percent slopes
Map Unit Setting
National map unit symbol: 1)pty
Mean annual precipitation: 49 to 58 inches
Mean annual air temperature: 70 to 77 degrees F
Frost -free period., 350 to 365 days
Farmland classification: Not prime farmland
Map Unit Composition
Arents and similar soils: 100 percent
Estimates are based on observations, descriptions, and transects of the mapunit.
Description of Arents
Setting
Landform: Ridges on marine terraces
Landform position (three-dimensional): Rise
Down -slope shape: Convex
Across -slope shape: Linear
Parent material: Altered marine deposits
Typical profile
C - 0 to 80 inches: variable
Properties and qualities
Slope: 45 to 65 percent
Depth to restrictive feature: More than 80 inches
Natural drainage class: Well drained
Runoff class: Negligible
Capacity of the most limiting layer to transmit water (Ksat): High to very high (5.95
to 19.98 in/hr)
Depth to water table: More than 80 inches
Frequency of flooding: None
Frequency of ponding: None
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: Low (about 3.6 inches)
Interpretive groups
Land capability classification (irrigated): None specified
Land capability classification (nonirrigated): 7e
Hydrologic Soil Group: A
Forage suitability group: Forage suitability group not assigned (G156BC999FL)
Hyddc soil rating: No
10
Custom Soil Resource Report
25—Nettles and Oldsmar sands
Map Unit Setting
National map unit symbol., ljpvl
Mean annual precipitation: 49 to 58 Inches
Mean annual air temperature: 70 to 77 degrees F
Frost -free period: 350 to 365 days
Farmland classification: Farmland of unique importance
Map Unit Composition
Nettles and similar soils: 40 percent
Oldsmar and similar soils. 40 percent
Minor components: 20 percent
Estimates are based on observations, descriptions, and transacts of the mapunit.
Description of Nettles
Setting
Landform: Flatwoods on marine terraces
Landform position (three-dimensional): Talf
Down -slope shape: Linear
Across -slope shape: Linear
Parent material: Sandy and loamy marine deposits
Typical profile
A - 0 to 8 inches: sand
E - 8 to 33 inches: sand
Bhl - 33 to 39 inches: sand
Bh2 - 39 to 55 inches: sand
Big - 55 to 80 inches: fine sandy loam
Properties and qualities
Slope: 0 to 2 percent
Depth to restrictive feature: 31 to 50 inches to ortstein
Natural drainage class: Poorly drained
Runoff class: 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 18 inches
Frequency of flooding: None
Frequency of ponding: None
Salinity, maximum in profile: Nonsallne 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 1.6 inches)
Interpretive groups
Land capability classification (irrigated): None
Land capability classification (nonirrigated): 4w
Hydrologic Soil Group: C/D
11
( 4
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Ben Gotti
CONTRACTOR / AGENT:
LOT: 5 687
Arnold Surveying, Inc.
BLOCK: P
APPLICATION # AP1246673
PERMIT # 55-SF-1692824
DOCUMENT # SE1001116
SUBDIVISION: Harmony Heights ID#: 1431-701-0280.000-5
TO BE COMPLETED BY ENGINEER, HEALTH OEPAkTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST
PROVIDE REGISTRATION NUMBER AND SIPN.ANDUSEAW,4ZACB{PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMSS
TOTAL ESTIMATED SEWAGE
AUTHORIZED SEWAGE FLOW:
UNOBSTRUCTED AREA AVAII
k f.*s [ ]NO NET USABLE AREA AVAILABLE: 0,86 ACRES
S PER DAY [I RESIDENCES-TABLEI / OTHER -TABLE 2 ]
S PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
SOFT UNOBSTRUCTED AREA REQUIRED: 562.50 SOFT
BENCHI-MM/REFERENCE POINT LOCATION: FND 5/8" IRC
ELEVATION OF PROPOSED SYSTEM SITE 41.00 I rl
ELEV 24.35'
/ FT ] [ ABOVE /I BELOW II 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: FT NON -POTABLE: 50 FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 14 FT POTABLE WATER LINES: 35 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES EX ]NO 30 YEAR FLOODING? [ ]YES [X]NO]
30 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
SOIL PROFILE INFORMATIC14 SITE 1 SOIL PROFILE INFORMATION SITE 2
USDA SOIL SERIES:Oldamer sand
Munsell #/Color Texture
Depth
10YR 3/1
Sand
0 To 12
10YR 5/2
Sand
12 To 25
10YR 4/1
Sandy Clay Loam
25 To 29
10YR 411
Sand
29 To 36
10YR 512
Sand
36 To 40
1 OYR 612
Sand
40 To 59
1 OYR 518
MANY/PRM RF
41 To 59
1 OYR 3/2
Sand
59 To 63
1 OYR 3/4
Sand
63 To 72
USDA SOIL SERIES:Oldamar sand
MUnSaiiii/Co[or Texture
Depth
Sand
0 To 17
YR`�512 `
Sand
17 To 30
10 .,R &1
Sandy Clay Loam
30 To 34
'10Y.F3�4/tk;, <;•.�
Sand
34To41
Sand
41 To 47
1 OYR 66//2
Sand
47 To 64
1 OYR 5/8
MANYIPRM RF
48 To 64
1 OYR 3/2
Sand
64 To 72
OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: ( PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 41 INCHES ( ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 41.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: 34 INCHES
DRAINFIELD CONFIGURATION: I ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
r• REMARKS/ADDITIONAL CRITERIA
EWSWT determined using USDA WSS, soH borings and topography. M " ":� ,. �, m'
41" below SM. S82 36" below BM
SITE EVALUATED BY:
DH 4015, 08/09 (Obsoletes previous edltio.ohich may not ha used) Incorporated: 64E-6.001, £AC
4
AP1246673 EID1692824 v1.0.2
tiv�
_ STATE OF FLORIDA PERMIT #. I
' DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
, K SITE.EVALUATION�ilUD#eSTEM PPE IFICATIONS
APPLICANT: BEN GOTTI775-285-6315 a/€ AGENT: ARNOLD SURVEYING, INC.
LOT: 5,6&7 BLOCK: P SUBDIVISION: HARMONY HEIGHTS ADDITION
PROPERTY ID #: 1431-701-0280-000-5 [Ta IDNumber
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:
ACRES
TOTAL ESTIMATED SEWAGE FLOW:
200
GALLONS
PER DAY [RESIDENCES-TABLET/OTHER-TABLE2
]
AUTHORIZED SEWAGE FLOW:
240
GALLONS
PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE
]
UNOBSTRUCTED AREA AVAILABLE:
SQFT
UNOBSTRUCTED AREA REQUIRED:
SQFT
BENCHMARK/REFERENCE POINT LOCATION: TOP OTr1RC AT THE{SOi]THWE51' CORNER OF LOT
ELEVATION OF PROPOSED SYSTEM SITE IS 4 �"*,,,.I FI1i .-] ][ IOW ] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINEW FRCM"THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: 75 FT DITCHES/SWALES: 10 FT NORMALLY WET? [ ] YES [ ] NO
WELLS: PUBLIC: 200 FT LIMITED USE: 100 FT PRIVATE: 75 FT NON -POTABLE: 50 FT
BUILDING FOUNDATIONS:7 FT PROPERTY LINES: 10 FT POTABLE WATER LINES: 10 FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ ] NO 10 YEAR FLOODING? [ ] YES [ ] 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
MUNSELL #/COLOR TEXTURE DEPTH--],MUNSELL #/COLOR TEXTURE DEPTH
1To:
USDA SOIL SERIES:.
OBSERVED WATER TABLE: INC
ESTIMATED WET SEASON WATER TABLE
HIGH WATER TABLE VEGETATION: [ ]
SOIL SERIES:
k
i 7 BELO cW�,yy' !] !I, ISTING GRADE. TYPE: [ PERCHED / APPARENT ]
.� IV _' INCHES [.ABOVE./BELOW ] EXISTING GRADE
W cm MOTTLING: [ ] YES [ ] NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION:
DRAINFIELD CONFIGURATION: [ ] TRENCH [ ] BED ,[ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA: -
SITE EVALUATED BY
: 06/02/2016
INCHES
DH 4015, 08/09 (obsoleL1e�pi� i:au ad!L-tioAi�—which may mused) Inc4orated: 64E-6.001, FAC
Page 3 of 4
- STATE OF FLORIDA PERMIT No.
2
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID:
_ SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[ ,/ I New System [ ] Exis f,i e
ng %S: [ ] Holding Tank [_ a [
' ] ��, a ive
e,...
[ ] Repair [ ] do [ ] Temporary [ ] s,
r^ba{�� ._ l
APPLICANT: BEN GOTTI 775- - 5
AGENT: ARNOLD SURVEYINGTELEPHONE: 772-460-8211
L
MAILING ADDRESS: 4888 N KINGS F3WY#425, 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 (Mbl/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS.
PROPERTY INFORMATION
LOT: 5,6&7 BLOCK: P SUBDMSION: HARMONY HEIGHTS ADDITION PLATTED: 1954
PROPERTY ID #: 1431-701-0280-000-5
ZONING: RS4 I/M OR EQUIVALENT: [ No ]
PROPERTY SIZE: 0.86 ACRES WATER SUPPLL.X^. [ ] PRIVATE PUBLIC [</]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 8140065, FS?r?.Q) I�O ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: 4600 G B DIVE �O[t P R & FL 34946
A.ir�.
DIRECTIONS TO PROPERTY: FRO, vI K�jNGS iI i YID ANGLE ROAD, GO SOUTH ON ANGLE ROAD TO
k
53RD STREET, NORTH ON 53RD STREET OVER BELCHER CANAL, TURN RIGHT (EAST) ON GRADY DRIVE,
SITE IS ON LEFT.
BUILDING INFORMATION
[</] RESIDENTIAL
'[
] COMMERCIAI,
Unit
Type of
No. of Building
Commercial/Institutional System Design
No
Establishment
Bedrooms Area Sqft
Table
1, Chapter 64E-6, FAC
1
SINGLE FAMILY
2 1280
2
3
[ ] Floor/Equipment D
aims I ' ] C
SIGNATURE:
DH 4015, 08/09 O so etas revi.ous
Incorporated 64E-6.001, 'FAC.- .
not be used)
DATE : 06/02/2016
Page 1 of 4
i
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR:
APPLICANT: Ban Gott)
PROPERTY ADDRESS:
FL 34946
LOT: $,6&]"HLO�? P SUBDIVISION:
"N
PROPERTY ID #: 1431-701-028"00-5
PERMIT #: 56-SF-1 692824
APPLICATION #:AP1246673
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1024965
Harmony Heights
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NMABER]
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 Septic
A [ ] GALLONS / GPD N/A
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM C
K ( ] GALLONS DOSING. TANK CAPACITY [ ] _V1
D [ 375 ] SQUARE FEET SYSTE`!,f a�
R [ ] SQUARE FEET NIA S v
A TYPE SYSTEM: [x] STANDARD [ ] FILLED i". ,40U1
v
I CONFIGURATION: [x] TRENCH [ ) BED [ ]y�."`�j
N
F LOCATION OF BENCHMARK: FND 5/8" IRC (NO ID) ELEV 24.35'
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: [ 1.001 INCHES
O
T
H
E
R
7K:1250 GALLONS]
PER 24 HRS #Pumps [
( 41.00 1 [1 INCHES V FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
[ 58.001[ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
is system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow
300 gpd.
is licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with
54E-6.013(3)(0, FAC.
SPECIFICATIONS BY: Brian J
APPROVED BY:
TITLE:
: Environmental Specialist I
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
v 1.1.4 AP1246673 SE1001115
I
CHD
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 beinwriting 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'QIN # A02, Tallahassee, Florida 32399-1703. The
Agency Clerk's facsimile number s�850.Ud 1448.
Mediation is not avadabte aszanda te' five remedy:
Your failuretto submit aYp�eti4Thing within 21 days from receipt of this order
will constitute a waiv�r o�ftyo ng,t f'�,n d, 1 istrative hearing, and this order shall become
a 'final order'. z"4
Should this ord • r% co�r'r final order, a party who is adversely affected by it is
entitled to judicial review - rsuant 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.