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HomeMy WebLinkAboutD O H PAPERWORKAPPLICATION #:AP1214928 STATE OF FLORIDAf)PERMIT #:56 SF-1645887 S - DEPARTMENT OF HEALTH DOCUMENT #:FI1088682 q ,1' ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AM FINAL APPROVAL DATE PAID:04/25/2016 •~�O w' FEE PAID:55.00 , RECEIPT #:56-PID-2928426 APPLICANT: Standard Pacific of Florida GP, Inc. AGENT: The Milcor Group, Inc. PROPERTY ADDRESS: 13316 NW Baywood PI Palm City, FL34990 BY LOT: 36 BLOCK: St. Lucie County SUBDIVISION: Riverbend ID#: 4425-703-0041.000.4 CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION SETBACKS [ ] [01] TANK SIZE [1) 800.00 [21 483.00 [ ] [271 SURFACE WATER FT [ J [021 TANK MATERIAL Concrete I 1 (281 DITCHES FT I 1 [031 OUTLET DEVICE [ ] [291 PRIVATE WELLS FT [ 1 [041 MULTI -CHAMBERED [ Y N ] [ J [301 PUBLIC WELLS FT [ 1 [051 OUTLET FILTER [ ] [311 IRRIGATION WELLS FT [ 1 [061 LEGEND 1. 28-015-AA2C3 2. 70-143-54SC4. [ 1 [32] POTABLE WATER 50 FT [ 1 [071 WATERTIGHT [ 1 [331 BUILDING FOUNDATIONS 5 FT [ 1 [081 LEVEL [ 1 [341 PROPERTY LINES $ FT [ 1 [091 DEPTH TO LID [ 1 [351 OTHER FT DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM [ 1 [101 AREA [1] 600 [21 SQFT [ 1 [361 DRAINFIELD COVER [ 1 1111 DISTRIBUTION BOX HEADER x I 1 [371 SHOULDERS [ 1 [121 NUMBER OF DRAINLINES 1. 3.00 2. [ 1 (381 SLOPES [ ] [131 DRAINLINE SEPARATION [ 1 [391 STABILIZATION 12/20/2016 [ ] [141 DRAINLINE SLOPE [ -1 1151 DEPTH OF COVER ADDITIONAL INFORMATION [ 1 [161 ELEVATION [ ABOVE / BELOW ]BM 11.00 I 1 1401 UNOBSTRUCTED AREA [ 1 (17) SYSTEM LOCATION [ ] 1411 STORMWATER RUNOFF [ 1 [181 DOSING PUMPS 1.00 1 1 1421 ALARMS [ ] [191 AGGREGATE SIZE, [ ] [431 MAINTENANCE. AGREEMENT I 1 [201 AGGREGATE EXCESSIVE FINES [ ] 1441 BUILDING AREA I 1 [211 AGGREGATE DEPTH [ 1 1451 LOCATION CONFORMS WITH SITE PLAN [ 1 [461 FINAL SITE GRADING FILL / EXCAVATION MATERIAL [ 1 [471 CONTRACTOR Brian Davis (Brian Davis Sep [ 1 [221 FILL AMOUNT [ 1 [481 OTHER Drip Irrigation - Netafim [ ) [231 FILL TEXTURE [ 1 [241 EXCAVATION DEPTH ABANDONMENT [ ] 1251 AREA REPLACED [ 1 [491 TANK PUMPED [ 1 [261 REPLACEMENT MATERIAL [ ] (501 TANK CRUSHED 6 FILLED Comments: Comments are on page 2. / St. Lucie CHD DATE: 11103/2016 CONSTRUCTION I APPROVED DISAPPROVED 1: Etivironmental w Spec tst ll Brian rt8ram(ENVIRONMENTAL HEALTH) FINAL SYSTEM I. APPROVED / DISAPPROVED 1: 1 St. Lucie CHD DATE: 12122/2016 nv r nmanta pea a s t n m viR0IT RNTACFEALTH) (Explanation of Violations an following Pagel DR 4016r 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003t FAO Page 2 of 3 EH Database v 1.0.1 AP1214928 EID1646887 RECEIVED DEC 27 2016 - STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL Violation Number Comment Comments APPLICATION il:AP1214928 PERMIT s:56-SF-1645887 DOCUMENT n:F11088682 DATE PAID:04/25/2016 FEE PAID:55.00 RECEIPT »:56-PID-2928426 The system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of 460 gpd. 800gal/day AA800 ATU 28-015-AA2-C3 // 483gal pretreatment tank 70-143-54S-C4 p 483gal dosing tank 70-143-54S-C4 // 1/2 hp 4' submersible effluent pump 20DOM05121+1-01 22C16G Y 1" 150 mesh strainer TAV-FO10 3x100 ft long netafim drip emitter in recirculating loops. No violations, system ok to cover. Contractor notified onsite. Needs final inspection for mound system, gutters, alarm check, maintenance agreement. PE sign off required for final system approval. ME contract received 12/22/16. Final system approved. Contractor and building department emailed final approval. DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 2 of 3 EH Database v 1.0.1 AP1214926 EID1646007 ] r . STATE OF FLORIDA SCANNED PERMIT NO. t DEPARTMENT OF HEALTH BY DATE PAID: f ONSITE SEWAGE TREATMENT AND D&Pb b County FEE PAID: t4Z) C c SYSTEM RECEIPT #: APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: IX ] New System [ ] Existing System [ ] Holding Tank [ ] Repair [ ] Abandonment [ ] Temporary APPLICANT: Standard Pacific of Florida GP, Inc. AGENT: The Mi1Cor Group, Inc. [ ] Innovative [ ] TELEPHONE: 772-223 -8850 MAILING ADDRESS: 6526 S Kanner Highway, Stuart, FL 34997 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: 36 BLOCK: SUBDIVISION: Riverbend PROPERTY ID #: 4425-703-0041-000-4 PLATTED: ZONING: PUD I/M OR EQUIVALENT: I Y / N ] PROPERTY SIZE: 0.52 ACRES WATER SUPPLY: [ ] PRIVATE UBLI [ X]<=2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y / © ] DISTANCE TO SEWER: N/A FT PROPERTY ADDRESS: 1331G NW Baywood Place, St. Lucie County, FL • DIRECTIONS TO PROPERTY: East On Becker Rd. for approximately 2.5 miles to Gilson Rd. Then north on Gilson Rd. for approximately a mile. Then East on AW—RaE[cllff Way. BUILDING INFORMATION Unit Type of No Establishment 1 Single Family 011 [ X] RESIDENTIAL I ] COMMERCIAL No. of Building Commercial/Institutional System Design Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC 4 3,688 3 4 I ] Floor/ ' nen D ains 1: Other (Specify) SIGNATURE: DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, PAC Page 1 of 4 STATE OF FLORIDA PERMIT #. DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONyS APPLI T• "A 2CLUrkC. OC CInnC.AGENT:� 4 uurr/ /1 I (] C . LOT: BLOCK: SUBDIVISION:Lywy ►^V PROPERTY ID #: H49- - 03-WAI -CQL `[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: [ ] YES [ ] NO NET.USABLEE IF ACRES TOTAL ESTIMATED SEWAGE FLOW: GALLONS PER DAY [R8 vurva_ma i/nmwFu-TABLE2] AUTHORIZED SEWAGE FLOW: GALLONS PER DAY [1500 GPD/ACRE 0RC2500 GPD A UNOBSTRUCTED AREA AVAILABLE: SQFT UNOBSTRUCTED AREA REQUIRED: SQFT D n n BENCHMARK/REFERENCE POINT LOCATION: /-� /• /kA/ �, ti _uL, �i hta� G at �+�'aF4i't' �(� (-t✓ �U. // ELEVATION OF PROPOSED SYSTEM SITE IS O Ch4IGRWFT7 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 [ ] NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT BUILDING FOUNDATIONS: FT PROPERTY LINES: FT POTABLE WATER LINES: FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YE [/] NO 10 YEAR FLOODING? [ ] YES [A NO 10 YEAR FLOOD ELEVATION FOR SITE: _19T MSL/NGVD SITE ELEVATION: O-('( Ll FT MSL/NGVD SOIL PROFILE INFORMATION SITE 1 MUNSELL #/ OLOR TEXTURE DEPTH G( Y S C9TO6 D ( TO z 2 O G TO TO TO TO TO - USDA SOIL SERIES: '-t/'tip TO %°M OBSERVED WATER TABLE: l0 INCHES [ABOVE / ESTIMATED WET SEASON WATER TABLE ELEVATI HIGH WATER TABLE VEGETATION: [ ] YES [/] SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DRAINFIELD CONFIGURATION: [X TRENQ)i 1 ] SITE EVALUATED BY SOIL PROFILE INFORMATION SITE 2 MUNSELL #/COLOR TEXTURE DEPTH U /// TO U TO TO ?� 2, q11L�r-, O b Y TO TO TO TO USDA SOIL SERIES: /•-',j W1 EXISTING GRADE. TYPE:[PERCHED AP N INCHES [ABOVE / L W]' EXIS E O�T>TLING: [ J ES [ ] DEPTH:/ INCHES Z� DEPTH OF EXCAVATION: INCHES [ ] OTHER (SPECIFY) lG /mil HATE: l r / Mr DH 4015, 08109 (Obsoletes previous editions which may not be used) Incorporated: 64E.6.001, FAC Page 3 of 4 REPRESENTATIVE AUTI4ORIZATION Riverbend Subdivision Please be advised that the undersigned has authorized the following person(s) to act on their behalf in seeking approval for the above referenced application: Melissa G. Corbett, P.E. The Milcor Group, Inc. 6526 South Kanner Highway #236 Stuart, Florida 34997 (772) 223-8850 Witness% cStUfi h) rS �c (nc�' EY tName Print Name ACKNOWLEDGEMENT STATEOF —rylc` COUNTY OF ��z( n The foregoing was acknowledged before me this day of / " /�J �J`^V')e_ 20 (i by �l�b N CCIp and K] is personally known to me or [ ] has produced as identification. ao Notary Stamp Notary Public SIVAN SHACHAR •r \?.t MY COMMISSION YIOFC07026 EXPIRES April 10. 2017 °:,.".•• (g07I 3980157 FloAtlaNOlsuyScrvlco.com APPLICANT'S NAME: Standard Pacific of Florida GP, Inc. LEGAL DESCRIPTION: Riverbend (PB 67-36)- Lot 36 I certify that there are no potable private wells within 75 feet of the available area for the proposed septic system, that there are no non -potable wells within 50 feet of the available area for the proposed septic system, that there are no wells within 25 feet of a pesticide -treated building foundation, that there are no public wells that serve less than 25 people or less than 15 homes or businesses within 100 feet of the proposed septic system, that there are no public wells that serve more than 25 people or more than 15 homes or businesses within 200 feet of the proposed septic system, that the water line from the water meter or well to the structure is at least 10 feet from the available area for the proposed septic system unless the plans show the line to be double sleeved, that there is not a gravity sewer line, low pressure sewer line or vacuum sewage line in a public easement or right-of-way that abuts the property, that there are no lakes, streams, wetlands, or surface water within 75 feet of the available area for the proposed septic system unless the property was created prior to 1972, that the septic system is proposed on the side of the lot farthest from surface water, that all private wells, septic systems and surface water on adjacent or contiguous land within 75 feet of the applicant's lot are shown on the site plan, that all public wells within 200 feet of the applicant's lot are shown on the site plan, and that the location of building or residences, swimming pools, recorded easements, paved areas or driveways, sidewalks, the general slope of the property, filled areas, drainage features, and surface waters such as lakes, ponds, streams, canals, or wetlands are shown on the applicants lot. The natural grade elevation in the area of the proposed septic system and the benchmark must be shown on the site plan. Please locate the benchmark within 200 feet of the proposed septic system. ,``�,►u a n„�••I a i V:= a o 6•• 'C7.W tq' * W NOTE: MUST BE CERTIFIED BY A FLORIDA CD.. t&TIFIEY. REGISTERED SURVEYOR OR ENGINEER. : �i;.FLORIDA A(RF�S] 111 4 _ JOB NO.: docs/foms/scptics/ScpticApppPagc207 ••Ii. Property Card Sitp Address 13316 NW Baywood PL Map ID: 44/25S Ownership Standard Pacific Of Florida 15360 Barranca Pkwy Irvine, CA 33609 Parcel ID: 4425-703-0041- Account#:176857 000-4 Zoning: PUD Use Type: 0000 Legal Description RIVERBEND (PB 67-36)- LOT 36 Sec/Town/Range: 25/37SI40E Jurisdiction: Saint Lucie County Current Values Historical Values 3-year Just/Market: $60,700 Assessed: $60,700 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $60,700 2015 $60,700 $60,700 $0 $60,700 2014 $60,700 $60,700 $0 $60,700 2013 $60,700 $60,700 $0 $60,700 Sale History Date Book/Page Sale Code Deed Grantor Price 11-26-2012 3460 / 0152 0205 SP Stuart Property Holdings Ltd, $7,000,000 Primary Building Information Finished Area of this building: 0 SF Gross Area of this building: 0 SF Exterior Data View: Year Built: N/A Primary Wall: Bedrooms: 0 Full Baths: 0 Half Baths: 0 Type 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°/u Heat Type: Avg Hgt/Floor: 0 Sprinkled %: 0% Heat Fuel: Primary Floors: lmnge Total Areas 01' Finished/Under Air 0 Sketch (SF): Ut]av'ail lble Gross Area (SF): 0 for display Land Size (acres): 032 Land Size (SF): 22,651 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 2015 Saint Lucie County Property Appraiser. All rights reserved. Page 1 of 1 http://www.pasle.org/RFCard/ 12/3/2015 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS New PERMIT #: 56-SF-I 645887 APPLICATION #:AP1214928 DATE PAID: FEE PAID: RECEIPT #: �� , z;*I*f *.] APPLICANT: (Standard Pacific of Florida GP, Inc.) PROPERTY ADDRESS: 13316 NW Haywood PI Palm City, FL34990 \ LOT: 36 BLOCK: PROPERTY ID #: 4425-703-0041-000-4 SUBDIVISION: Riverbend [SECTION, TOWNSHIP, �ANGE, 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 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 SHE #Pumps [ ] D [ 575 ] SQUARE FEET Drainfleld 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: pop nail In CWB near Center Of lot "elev 10.48" I ELEVATION OF PROPOSED SYSTEM SITE [ 0.00 ][INCHES FT ][ABOVE BELOW] BENCHMARK/REFERENCE POINT -E BOTTOM OF DRAINFIELD TO BE [ 10.0011 INCHES FT ][ABOVE BELOW] BENCHMARK/REFERENCE POINT L D 0 T H E R •. aaaYulnzu: r LO.UUJ 11V1 nzS znu+vx'riur, uytuinzu: l J in�.nza e system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow 460 gpd. e licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with 64E-6.013(3)(0, FAC. SPECIFICATIONS BY: Brian Davis TITLE: Master Septic Tank Contractor . APPROVED BY: /„/�� 1-15A� TITLE: Environmental Specialist I St. Lucie CHD Brian Ingram DATE ISSUED: 12/08/2015 EXPIRATION DATE: 06108/2017 DH-4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 v 2.1.4 AP1214928 SE978923 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 # A02, Tallahassee, Florida 32399-1703. The Agency Clerk's facsimile number is 850-410-1448. 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'fiinal 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. STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT PERMIT #:56-SF-1529651 APPLICATION #:AP1141181 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR934759 CONSTRUCTION PERMIT FOR: OSTDS New SCANNED APPLICANT: (Standard Pacific of Florida GP Inc.) BY PROPERTY ADDRESS: 13320 NW Baywood PI Port Saint Lucie, FL 34952 LOT: 35 1 PROPERTY ID #: BLOCK: 4425-7030-0400-000-7 SUBDIVISION: Riverbend [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] r SYSTEM MUST HE 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 T [ 1,350 ] GALLONS / GPD Septic 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 [ 867 ] SQUARE FEET Drainfleld SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [x] FILLED [] MOUND [ ] I CONFIGURATION: [ ] TRENCH [X] BED [ ] N F LOCATION OF BENCHMARK: Catch basin 220' Ne prop corner I ELEVATION OF PROPOSED SYSTEM SITE [ 16.00 111 INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 18.001C INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D E O T H E R LLL 3(L �[V J.1tGV: r IO.VUJ 11V 1. [ILJ tuuY�ia�[.v. L J The system is sized for 5 bedrooms with a maximum occupancy of 10 persons (2 per bedroom), for a total estimated flow of 520 gpd. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E-6.013(3)(0, FAC. SPECIFICATIONS SY/ pn ew R Gatewood TITLE: Environmental Specialist II APPROVED BY: ` TITLE: Environmental Specialist II St. Lucie CHD Andrew R Gatewood DATE ISSUED: 03/31/2014 EXPIRATION DATE: 09/30/2015 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 AP1141181 SE924282 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 120.67, 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 # A02, Tallahassee, Florida 32399-1703. The Agency Clerk's facsimile number is 850410-1448. 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.