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HomeMy WebLinkAboutD O H PAPERWORK• n Mission: To dtotect promote & improve the health of all people in Florida through integrated state, county & community efforts. 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 Effective July 24, 2017 BY 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-WELLS ar.FLHEALTH.GOV, RECEIVED b. Provide the following information: APR 12 2019 i. Permit number ii. Driller name 5r. Lime County, Permitting ill. 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(i)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 Port St Lurie, FL34983 PHONE: 772/873-4931 • FAX: 7721595-1306 FloridaHealth.gov REVIEWED FOR CODE COMP9aMNCE ST. LUCIE COUNTY BOCC Accredited Health Department Public Health Accreditation Board +tc, K0.5ln -SF-I STATE OF FLC' .1 PERMIT APPLICATION TO CONSTRUCT, REPAIR, MODIFY, OR ABANDON A WELL ❑Southwest PLEASE FILL OUTALLAPPLICABLE FIELDS ❑ Northwest ('Denotes Required Fields Where Applicable) ❑St. Johns River ❑South Florida The waWwedcontracier3responsible forcovMlevg ftbrm andfonvarring fie pen ndapprmallon to the ❑Suwannee River appropriate delegatodauth.Wwhen, applicable. ❑ DEP O Delegated Authority (if Applicable) L No._ 59-29261 Unique ID Stipulations Required (See Attached) No. Dermea6on { L [7g?- 'State 21P 'ParceIlDN (PIN)or Attennaatte,l�ey (Circle One p[/'.., Lot Block Unit 4 J 79 Check if 62-524: _Yes — - No 'Seytion or Land Grant e 'Co wnship Rang.unty Subdivision 5. /JZvr/s i� ' ,� 11_ 7'/2�'Z7 i L33igccidCfGDn �ilr�rm,rCs�., 'Water ellrContractor nse Number 'Te ephon"� a Number E-mail Address 7 — 'Water Well Contractor's Address C State ZIP 7. •Type of Work: V Construction _Repair _Modification _Abandonment 8. *Number of Proposed Wells Tteasonra RePaic h7ndkfimEon,crAbando meet 9.'S ' Intended Use(s) of Well(s): d O Domestic Landscape Irrigation _Agriwltural Irrigation Site Investigation Bottled Water Supply _Recreation Area Inrgation _Livestock _Monitoring Nursery Irrigation _Test Public Water Supply (Limited H)—Nursery Earth-Coupled Geothermal MAR 2 ' 201C Public Water Supply (Communitypity or or Nan-CommunitylDEP) —Golf Course Irrigation _HVAC Supply _Class I Injection _HVAC Return Class V Injection: _Recharge _CommerciaUlndushial Disposal Aquifer Storage and Recovery _Drainage DOH In St Lucie COL Remediation: _Recovery AirSparge _Other(oesaibe) F 1AR 6b1TAyHFJ Other (oes ) (None: Not ao typo a a pen by g'a'ea Permk�9 aummy) 10: Distance from Septic System lfs200 it t 11. Facility Description /- "-t e� 12. Estimated Start Date 13.'Fstimated Well Depth �' !eft 'Fstimated Casing Depth 3ZI ft 'Primary Casing Diameter r L in. Open Hole: From _ -ion- R 14. Estimated Screen Interval: From.-3�L—Te3S­ft. 15.•Primary Casing Material: _Black Steel galvanized _PVC _Stainless Steel _NotCased _Other: , 16. Secondary Casing: Telescope Casing _Liner �_ Surface Casing Diameter in. • . 17. Secondary Casing Material: _Black Steel _Galvanized VC _Stainless Steel _Other 18.'Method of Conshuction, Repair, erAbandonment Auger _Cable Tool _Jetted _Rotary. _Sonic _Combination (Two or More Methods) _Hand Driven (Well Point, Sand Point) _Hydraulic Point (Direct Push) _Horizontal Driking _pluggedjy 1pp ved Method _Other (oesclee) 19. Proposed Grouting Interval for the Pri S ndary, and Additional Casing: From l To Seal Mate' I entonita_. Neat Cement Other 1 From To Seal Me -al entonite Neat Cement _Other ) From�To 'Seal M rial atonde_Neat•Cement_Other ) From To Seal Me vial i entonite_Neat Cemeni Other ) 20. Indicate total numberofexisting wells onsfte / List number of existing unusedwells on site 21:is this well or anyexisting well orwaterwifhd wal on the owner's contiguous property covered undera ConsumptivelWater Use Permit(CUPIWUP) or CUPMNP Application? —Yes _No If yes, complete thefollowing: CUPIWUP No. District Well ID No. 22. Latitude Longitude 23. Data Obtained From: _GPS _Map _Survey Datum:NAD 27 NAD 83 WGS 84 �tereeyuA'ry tivrlWamprymiC,Eieappltaek NnofTi�a0. FIOMaOffimmamelcte.aalbazaealer Iraeaya vlain 0ieamerdUp YeDeT4 uetpr infamnYonpmNrJ bammm, aitl Nalam ¢.moony pmm¢aahfirial mtltagepmmLJreetlMlwpes awabe ohr�ad P,mrrooxronmwmenton,reu TdeauMc(naparar3.FM4a S1�,mtniNanaprorM/a0.umn Nh.eka.im¢y Tatlam oowNdim. IpWiaoe(L'.y Tat9 hkmufian0.'�d'n T@�mis nxxva2aMtlwllwadbm erea7•e4fa Qe arrc4 t@E�o'v0omeiUUeri poi�arilbaanatr.aM Eutllare WmMNsosraraNeu iepatbQ�e Oisbktw30�,abzl govrmmmb,VeppGotle. Iag�aao40aaweA iespv LfffJesysffi4V epo�e. Qamrm�w�btaa0wi6gpasmneldEicwda)a Wkgakd3u0raEyaccae 6rysaRereomgena, otPa mawc0ort repat¢modifivata:a,a bewxMSBeCa"vig Temrseurlidt raPa%moLGca5on,aaCantlwnentaWmRitl Cy aisremR atarammnrawwnaa try brio rtm�L ocAe ammaemd'afrcxl nlVyervaC.aas 9n'- 5ignaWre of Contractor _ cerxse No. 'Signature of Ovmer"Agent Date Approval Granted Issue Date 4f jM ` / Expiration Fee Received S Receipt No. Chi THIS PERMrr IS NOT VAUD. UNT)L PROPERLY SIGNED BYAN AUTHORIZED OFFICER OR REPRESENTATNE PERMrr SHALL BEAVAILABLEATTHE WELL SITE DURING ALL CONSTRUCTION, REPAIR MODIFICATION, OI DEPForm:62-532900(1) Incorpomtedin62-532.400(1),FAC. Effective Date: October 7,2010 Hydrologist Approval wsma THE Page 1 I ,I spa0 ti S89°08'48"W 1: Npgg• TRIIO x i � a i� �N 0 II PROPOSED WELL 1 4070' - I Itip. }tiO+ DIRTDRIVE _ �-BUILDING PAD I QI I •I I. T � • TDPOFBANK -.—. .--- � �h +ry\� tit• } DRAINAGEOITCN TOPOF&ANK; _ 1OPOFBANX ry� �; T DR41MAGEVrfW-- PROPOSED MANUFACTURMHOM 24.00' FINE H FLOOR EL 27.1 (3T'ABOVECROV NOFF f - -Il� err, 00O Lj1z51 \► AVAILABLEARFA \ TANKAND DRAINF FrcpeiAy Card Fage 1 of 1 Michelle Franklin, CFA — Saint Lucie County Property Appraiser — All rights reserved. Property Identification Site Address: Carlton RD Parcel ID: 4203-223-0001- Account H: 145683 Sec/fown/Range: 000-7 03/378/38E Map ID: 42/03X Zoning: AG-5 Use Type: 6000 Jurisdiction: Saint Lucie County Ownership Legal Description Michael C Crouse 3 37 38 S I/2 OF NW 1/4 OF NW 1/4-LESS W 100 FT - Erica Crouse (20.905 AC) 4524 NW Brownell TER Port St Lucie, FL 34983 Current Values Historical Values 3-year Just/Market: $186,600 Assessed: $186,600 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $186,600 2018 $186,600 $186,600 $0 $186,600 2017 $186,572 $5,750 $0 $5,750 2016 $70,659 $5,750 $0 $5,750 Sale History Date Book/Page Sale Code Deed Grantor Price 12-28-2018 4218 / I753 0001 WD Amerifunds Secured Income $180,000 FUnd I LLC I0-23-2017 4056 / 0153 0118 CT Patel Apurva S $140,100 10-12-2005 2401/1033 XX00 WD Gunn John 0 $500,000 Primary Building Information Finished Area of this building: 0 SF Gross Sketched Area: 0 SF Exterior Data View: Roof Cover: Roof Structure: Building Type: Year Built: N/A Frame: Grade: Effective Year: 2014 Primary Wall: Story Height: No. Units: 0 Secondary Wall: Interior Data Bedrooms: 0 A/C %: 0% Electric: Primary Int Wall: Full Baths: 0 Heated %: N/A% Heat Type: Avg Hgt/Floor: 0 Half Baths: 0 Sprinkled %: 0% Heat Fuel: Primary Floors: Total Areas f 5 y � pt Finished/(JnderAir 0 (SF): at:2tC!'• Gross Sketched Area 0 ?! (SF): 65r C!;' ,":-1; Land Size (acres): 20.91 Land Size (SF): 910,622 Total Building Count: 1 Special Features and Yard Items Type 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. .ttps://www.paslc.org/RECard/ 2/26/2019 PERMIT #:56-SF-1927948 STATE OF FLORIDA APPLICATION #:AP1400285 DEPARTMENT OF HEALTH RECEIVED DA PAID: ONSITE SEWAGE TREATMENT AND DISPO AL FE E PAID: SYSTEM APR 12 2019 RECEIPT #: ST. Lucie County, PermitffK§ NT #: PR1209020 SCANNED CONSTRUCTION PERMIT FOR: OSTDS New BY APPLICANT: Michael & Erica Crouse St. Lucie County PROPERTY ADDRESS: TBD Carlton Rd Port Saint Lucie. FL 34987 LOT: BLOCK: SUBDIVISION: PROPERTY ID #: 4203-223-0001-000-7 [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 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 [ 563 ] SQUARE FEET Drainfield new SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X] MOUND [ ] I CONFIGURATION: [X] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: nail In Sabel palm SW Of systerr I ELEVATION OF PROPOSED SYSTEM SITE [ 21.001[E3 E BOTTOM OF DRAINFIELD TO BE [ 11.00][C L Di 0 T H E R FT ][ABOVE 4 BELOW BENCHMARK/REFERENCE POINT FT ][ABOVE HELOW BENCHMARK/REFERENCE POINT REQUIRED: IZC.UUJ INCHES EXCAVATION REQUIRED: t J 1NCRSJ system is sized for 2 bedrooms with a maximum occupancy of 9 persons, for a total estimated flow of 450 gpd. am sized based on applicant proposed 9 person 4br/3ba future house. SPECIFICATIONS BY: Brian J Ingr;;sp TITLE: Environmental Specialist II APPROVED BY: ITLE: Environmental Specialist II St. Lucie CHD esian J In DATE ISSUED: 03/26/2019 EXPIRATION DATE: 09126/2020 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 A 1400285 SE1158707 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 HEALTH PAYING ON: #:56-SF-1927948 BILL DOC#:56-BID-4087716 CONSTRUCTION APPLICATION #: AP1400285 RECEIVED FROM: Zelaya's Mobile Home Movers AMOUNT PAID: $ 515.00 PAYMENT FORM: CREDIT CARD PAYMENT DATE: 02/26/2019 MAIL TO: Michael & Erica Crouse FACILITY NAME: PROPERTY LOCATION: TBD Carlton Rd Port Saint Lucie, FL 34987 Lot: Property ID: 4203-223-0001-000-7 EXPLANATION or DESCRIPTION: firs" 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 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 RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-3866740 a o STATE OF FLORIDA k DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: j>(] New System L ] Existing System [ ]' Repair /rr [ ] Abandonment A APPLICANT: /.y/ ' e-v/4�e/ AGENT: %is d O 1 9 'e di h AILING ADDRESS: " Lia,4412'l . �Aak k .. 5qt-2(g72-17 k PERMIT NO. S - f — DATE PAID: FEE PAID: La.ib om EL RECEIPT #: °`AQ-�AA. [ ] Holding Tank [ ] Innovative [ ] Temporary Q jd'�—, U d os, Q/ diePkmEPHONE: -).-7 , -,1 TOOBBE-COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE CONSTRUOTED BY A PERSON LICENSED PURSUANT.TO 489. 105(3)(m) OR 489.552; FLORIDA STATUTES. IT IS THE APPLICANTS 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 j�b2 °'sas.mn r.7 JUzj °e$� &J� Sic Urro j LOT: d4A BLOCK: SUBDIVISION: d'U t-{ _ PLATTED: -- PROPERTY ID #: /JS2 o3 ?Z3 0 ®®P t' 0o 7 ZO/N/I'NG: PROPERTY SIZE: 2U. //ACRES WATER SUPPLY: ['/] PRIVATE IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y /Q PROPERTY ADDRESS: DIRECTIONS TO PROPERTY: Ilk OR EQUIVALENT: [ Y / N ] PUBLIC [ <=2000GPD [ ]`>�20.000GPD DI'SrTANNCE TO SEWER: fV 1: FT ib ) W�-s+ BUILDING INFORMATION 90 RESIDENTIAL v ME [ ] COMRCIAL Unit Type of No. of . Building Commercial/I8stitutional System Design, No Establishment Bedrooms Area Sqft Table 1 Chanter 64E-6 i?AC DO act 2 3 4 [ ] Flo( SIGNATURE: [ (Specify) DATE: 7ZZf/�C! DH 4015? 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC Page I of 4 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: Michael & Erica Crouse CONTRACTOR / AGENT: Zelaya"s Mobile Home Movers LOT: BLOCK: SUBDIVISION: ID#: 4203-223-0001-000-7 APPLICATION If AP1400285 PERMIT # 56-SF-1927948 DOCUMENT # SE1158707 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: 20.91 ACRES TOTAL ESTIMATED SEWAGE FLOW: 450 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 31365.00 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 1200.00 SOFT UNOBSTRUCTED AREA REQUIRED: 844.00 SOFT BENCHMARK/REFERENCE POINT LOCATION: nail In Sabal palm SW Of System ELEVATION OF PROPOSED SYSTEM SITE 21.00 [ INCHES / FT ] [ ABOVE / BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: 75 FT DITCHES/SWALES: 75 FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 100 FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 100 FT POTABLE WATER LINES: 75 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO, 10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD ] SITE ELEVATION: FT [ MSL,/ NGVD cn TT. DRr1FTT.F. TN nPMATTnV CTTF 1 QnTT. DRO7TT.7. TN nWMLTTDN CTTR i USDA SOIL SERIES:Pineda sand Munsell #/Color Texture Depth 10YR 2/1 Sand 0 To 8 10YR 511 Sand 8 To 14 10YR 7/3 Sand 14 To 27 10YR 7/6 Sand 27 To 37 1 OYR 512 Sandy Clay Loam 37 To 48 HOLE CAVING Refusal 48 To 72 USDA SOIL SERIES:Pinada sand Munsell #/Color Texture Depth 1 OYR 211 Sand 0 To 3 10YR 5/2 Sand 3 To 9 10YR 7/2 Sand 9 To 20 1 OYR 711 Sand 14 To 26 1 OYR 7/6 Sand 26 To 37 10YR 412 Sandy Clay Loam 37 To 44 HOLE CAVING Refusal 44 To 72 OBSERVED WATER TABLE: 18.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: ( PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 14 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 14.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY) r REMARKS/ADDITIONAL CRITERIA determined using USDA WSS and soil borings. 1 stripping in 10YR7/2 matrix>10% with diffuse boundaries starting at 14" In S62. " below BM. SB2 21" belo"M. Z17 SITE EVALUATED BY: Ingram, Brian (Title: DH 4015, 08/09 (Obsoletes previous editions which INCHES 111� DATE: 03/08/2019 ronmental Specialist 10 (ENVIRONMENTAL HEALTH) not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 AP1400285 EID1927948 v 1.0.2 APPLICANT: /'" LOT: a STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS PERMIT #. ✓6=s�- NZ79V >JF�6 'AsL+�I 1.9V� AGENT: ✓'/�i. /'(CI t/ Lll z] d. A. 10101 14 SUBDIVISION: PROPERTY ID #: 4 &3 GG,J 000 06'e [Section/Township/Parcel No. or Tax ID Number] TO BE COMPLETED BY ENGINEER, HEALTH DEPARTEMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINNEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [ZYES [ ] NO NET USABLE AREA AVAILABLE: Z�_ACRES TOTAL ESTIMATED SEWAGE FLOW: GALLONS PER DAY [RESIDENCES -TABLE 1/OTHER-TABLE21 AUTHORIZED SEWAGE FLOW: GALLONS PER DAY 11500 GPD/ACRE OR 2500 GPD/ACRE] UNOBSTRUCTED AREA AVAILABLE: ��nn SQFT UNOBSTRUCTED AREA REQUIRED: SOFT BENCHMARK/REFERENCE POINT LOCATION: 13M �Z , M "- IVA-et �l /DaS I- 06e ,°4, ee ELEVATION OF PROPOSED SYSTEM SITE IS / GZ [INCHES=FT [ABOVEAELOW]JCBENCHMARK�REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: % S_ FT DITCHES/SWALES: Ir FT NORMALLY WET? [ ] YES [ ] NO WELLS: PUBLIC: Z®® FT LIMITED USE: f0 b FT PRIVATE: % S FT NON -POTABLE S C'� FT BUILDING FOUNDATIONS:_ FT PROPERTY LINES: 'S FT POTABLE WATER LINES: /yam. FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ ] NO 10 YEAR FLOODING? [ ] YES [ 1 NO 10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD ou" emux lL 1Ne VL(CJ.Y'xuv Jl'1'C; 1 MUNSELL #/COLOR TEXTURE DEPTH TO TO TO TO TO TO TO TO TO USDA SOIL SERIES: J V1L ClLVl 1LL 1LYL VLLL-YLI IVLY MUNSELL #/COLOR TEXTURE DEPTH TO USDA SOIL SERIES: TO TO TO TO TO TO OBSERVED WATER TABLE: INCHES [ABOVE / BELOW] EXISTING GRADE. TYPE: [PERCHED / APPARENT] ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [ABOVE / BELOW] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO MOTTLING: [ ] YES [ ] NO DEPTH: INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [ ] BED [ ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA: SITE EVALUATED BY: DATE DE 4015, 08/09 (Obsoletes Previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 • 'Property Card - Page 1 of 1 5G-sF-19279y5' Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved. Property Identification Site Address: Carlton RD Parcel ID: 4203-223-0001- Account #: 145683 Sec/Town/Range: 000-7 03/37S/38E Map ID: 42/03X Zoning: AG-5 Use Type: 6000 Jurisdiction: Saint Lucie County Ownership Legal Description Michael C Crouse 3 37 38 S 1/2 OF NW 1/4 OF NW 1/4-LESS W 100 FT - Erica Crouse (20.905 AC) 4524 NW Brownell TER Port St Lucie, FL 34983 Current Values Historical Values 3-year Just/Market: $186,600 Assessed: $186,600 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $186,600 2018 $186,600 $186,600 $0 $186,600 2017 $186,572 $5,750 $0 $5,750 2016 $70,659 $5,750 $0 $5,750 Sale History Date Book/Page Sale Code Deed Grantor Price 12-28-2018 4218 / 1753 0001 WD Amerifunds Secured Income $180,000 FUndILLC 10-23-2017 4056 / 0153 0118 CT Patel Apurva S $ I40, I00 10-12-2005 2401 / 1033 XX00 WD Gunn John O $500,000 Primary Building Information Finished Area of this building: 0 SF • Gross Sketched Area: 0 SF Exterior Data View: Roof Cover: Roof Structure: Building Type: Year Built: N/A Frame: Grade: Effective Year: 2014 Primary Wall: Story Height: No. Units: 0 Secondary Wall: Interior Data Bedrooms: 0 A/C %: 0% Electric: Primary Int Wall: Full Baths: 0 Heated %: N/A% Heat Type: Avg Hgt/Floor: 0 Half Baths: 0 Sprinkled %: 0% Heat Fuel: Primary Floors: hl ac;C Total Areas Of Finished/Under Air 0 (SF): Gross Sketched Area 0 (SF): (Ol' �lisj�l<;V Land Size (acres): 20.91 Land Size (SF): 910,622 Total Building Count: 1 Special Features and Yard Items Type 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. ittps://www.paslc.org/RECard/ 2/26/2019 { ♦ L itpW, I I I1 f if I t'dlf i 7h .�' a � - r fr-� .� • A IT4H A iIvN Custom Soil Resource Report Soli Map 56 SF- 19 2-7999 4 Mry5cVclV,llDFPN .AWN^L3pe(11'z8579e9. 6 N o m im MOl�N1���Nl�rMfcbr fmvvcNvtrs: NCS81 6igeLLxamlmelJNNCSBC 6 ARQN A RAN Custom Soil Resource Report St. Lucie County, Florida 32—Pineda sand, 0 to 2 percent slopes Map Unit Setting National map unit symbol: 2x1 nb Elevation: 0 to 100 feet Mean annual precipitation: 47 to 58 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 Pineda and similar soils. 85 percent Minor components: 15 percent Estimates are based on observations, Description of Pineda 6&-sr-- 19299&1Y descriptions, and transacts of the mapunit. Setting Landform: Drainageways on marine terraces, flats on marine terraces Landform position (three-dimensional): Tread, dip, tall Down -slope shape: Linear Across -slope shape: Concave, linear Parent material. Sandy and loamy marine deposits Typical profile A - 0 to 5 inches: sand E - 5 to 19 inches: sand law - 19 to 35 inches: sand Btg/E - 35 to 38 inches: sandy loam Btg - 38 to 60 inches: sandy loam Cg - 60 to 80 inches: loamy sand Properties and qualities Slope: 0 to 2 percent Depth to restrictive feature: More than 80 inches 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 3 to 18 inches Frequency of flooding: None Frequencyofponding: None Calcium carbonate, maximum in profile: 4 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: Low (about 4.6 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 over loamy soils on flats of hydre or mesic lowlands(G155XB241FL) Other vegetative classification: Slough (R155XY011 FL) Hydric soil rating: Yes Minor Components Malabar Percent of map unit: 6 percent Landform: — error in exists on — Landform position (three-dimensional): Tread, dip, talf Down -slope shape: Linear, concave Across -slope shape: Linear, concave Ecological site: Slough (R155XY011 FL) Other vegetative classification: Slough (R155XY011 FL) Hydric soil rating: Yes Wabasso Percent of map unit: 5 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: No Valkaria Percent of map unit: 2 percent Landform: Drainageways on flatwoods on marine terraces Landform position (three-dimensional): Tread, dip, tall Down -slope shape: Linear Across -slope shape: Concave, linear Other vegetative classification: Slough (R155XY011 FL) Hydric soil rating: Yes Hallandale Percent of map unit: 2 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 36—Pople sand Map Unit Setting National map unit symbol: ljpvy Elevation: 20 to 100 feet Mean annual precipitation: 49 to 58 inches Mean annual air temperature: 70 to 77 degrees F 11 Custom Soil Resource Report Frost -free period. 350 to 365 days Farmland classification: Farmland of unique importance Map Unit Composition Pople and similar soils: 85 percent Minor components: 15 percent Estimates are based on observations, descriptions, and transacts of the mapunit. Description of Pople Setting Landform: Flats on marine terraces, drainageways on marine terraces Landform position (three-dimensional): Dip Down -slope shape: Linear Across -slope shape: Concave Parent material. Sandy and loamy marine deposits Typical profile A - 0 to 3 inches: sand E - 3 to 29 inches. sand Btkg - 29 to 56 inches: sandy clay loam Cg - 56 to 80 inches., sandy loam Properties and qualities Slope: 0 to 2 percent Depth to restrictive feature: More than 80 inches 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 0 to 12 inches Frequency of flooding: None Frequency of ponding: None Calcium carbonate, maximum in profile: 20 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: Low (about 5.7 inches) Interpretive groups Land capability classification (irrigated): None specified Land capability classification (nonirrigated): 3w Hydrologic Soil Group: C/D Forage suitability group: Sandy over loamy soils on flats of hydric or mesic lowlands (G156BC241 FL) Hydric soil rating: Yes Minor Components Hilolo Percent of map unit: 3 percent Landform: Flats on marine terraces Landform position (three-dimensional): Talf Down -slope shape: Convex Across -slope shape: Linear Hydric soil rating. Yes EPA Custom Soil Resource Report Pineda Percent of map unit: 3 percent Landform: Flats on marine terraces, drainageways on marine terraces Landform position (three-dimensional): Dip Down -slope shape: Linear Across -slope shape: Concave Hydric soil rating: Yes Hallandale Percent of map unit: 3 percent Landform: Flats on marine terraces Landform position (three-dimensional): Interfluve, talf Down -slope shape: Convex Across -slope shape: Linear Hydric soil rating: No Winder, shell substratum, hydric Percent of map unit: 2 percent Landform: Flats on marine terraces Landform position (three-dimensional): Talf Down -slope shape: Concave, linear Across -slope shape: Linear Hydric soil rating: Yes Riviera Percent of map unit: 2 percent Landform: Flats on marine terraces Landform position (three-dimensional): Talf Down -slope shape: Linear Across -slope shape: Linear Hydric soil rating: Yes Winder, hydric Percent of map unit: 2 percent Landform: Flats on marine terraces Landform position (three-dimensional): Tait Down -slope shape: Concave, linear Across -slope shape: Linear Hydric soil rating: Yes 38—Riviera fine sand, 0 to 2 percent slopes Map Unit Setting National map unit symbol., 2tzw2 Elevation: 0 to 80 feet Mean annual precipitation: 44 to 59 inches Mean annual air temperature: 68 to 77 degrees F Frost -free period: 350 to 365 days Farmland classification: Farmland of unique importance 13 Custom Soil Resource Report Map Unit Composition Riviera and similar soils: 80 percent Minor components: 20 percent Estimates are based on observations, descriptions, and transacts of the mapunit. Description of Riviera Setting Landform: Flats on marine terraces, drainageways on marine terraces Landform position (three-dimensional): Tread, talf, dip Down -slope shape: Linear Acrossslope shape: Linear, concave Parent material: Sandy and loamy marine deposits Typical profile A - 0 to 6 inches., fine sand E- 6 to 28 inches: fine sand BdE - 28 to 32 inches., fine sandy loam Big - 32 to 42 inches: sandy clay loam C - 42 to 80 inches: fine sand Properties and qualities Slope: 0 to 2 percent Depth to restrictive feature: More than 80 inches Natural drainage class: Poorly drained Runoff class: Very high Capacity of the most limiting layer to transmit water (Ksat): Moderately high to high (0.60 to 6.00 in/hr) Depth to water table: About 3 to 18 inches Frequency of flooding: None Frequency of ponding. None Salinity, maximum in profile: Nonsaline to very slightly saline (0.0 to 2.0 mmhoslcm) Sodium adsorption ratio, maximum in profile: 4.0 Available waterstorage in profile: Moderate (about 6.0 inches) Interpretive groups Land capability classification (irrigated): None specified Land capability classification (nonirrigated); 3w Hydrologic Soil Group: AID Forage suitability group: Sandy over loamy soils on flats of hydric or mesic lowlands (G155XB241 FL) Othervegetativeclassification: Slough(R155XY011FL) Hydric soil rating. Yes Minor Components Wabasso Percent of map unit., 8 percent Landform: Flatwoods on marine terraces Landform position (three-dimensional): Tread, tall Down -slope shape: Convex, linear Across -slope shape: Linear Other vegetative classification: South Florida Flatwoods (R155XY003FL) Hydric soil rating: No 14 Custom Soil Resource Report Hallandale Percent of map unit: 4 percent Landform: Flatwoods on marine terraces Landform position (three-dimensional): Tread, talf Down -slope shape: Linear Across -slope shape: Linear Other vegetative classification: South Florida Flatwoods (R155XY003FL) Hydric soil rating: Yes Pinellas Percent of map unit: 4 percent Landform: Flatwoods on marine terraces Landform position (three-dimensional): Tread, talf Down -slope shape: Convex, linear Across -slope shape: Linear Other vegetative classification: Cabbage Palm Flatwoods (R155XY005FL) Hydric soil rating: No Floridana Percent of map unit: 2 percent Landform: Depressions on marine terraces Landform position (three-dimensional): Tread, dip Down -slope shape: Concave, linear Across -slope shape: Concave, linear Other vegetative classification: Freshwater Marshes and Ponds (R155XY010FL) Hydric soil rating: Yes Oldsmar Percent of map unit. 2 percent Landform: Flatwoods on marine terraces Landform position (three-dimensional): Talf. Down -slope shape: Convex, linear Acrossslope shape: Linear Other vegetative classification: South Florida Flatwoods (R155XY003FL) Hydric soil rating: No 15 �riccz Crouse Ccv 1% ol. i�ir�el do ` ZO3 - Z23 - 000' - OoO-1 " i q p��s t¢ �, ,; kH`IErN!'-3ii I6H _ E t i�IIzhli I �- 1 y. IIF ARN (PD . yi t. r � •� , is c ... . . .. ter. • � ,E�@I �p - ��, ur v ».�_ n .\.n q� T4�:�, .fir {r� . �' r FD(SH in St YlhiGe Coynty °` ' i Environmental Health aL; C' ` Sde plan Approved forConstruetiora: :Supersedes AI[ Previous Site -plans for ,.. , OSTDS & Well # Uate: 3 Z6 fR Reviewer: