HomeMy WebLinkAboutD O H PAPERWORKSTATE OF FLORIDA
DEPARTMENT OF HkALTO
ONSITZ SEWAGE TREATMOT AND DISPOSAL SYSTEMS
CONSTRUCT -VON INSPECTIONANp FINAL APPROVAI.
APPLICATION
PEr,mw #t56-SF--1929
m. , �
DATE PA
cic 4 -c.) "14 RECEIPT #.-66 -PID
APPLICANT- Ron Raythond Constnfnflnn
AGENT: Richard Laventure (Laventure &Associates Inc)
PROPERTY' ADDRESS: j180Bridle Way' Port Saint Lucie FL34987
pOT-- 20 BLOCK, BY
SUwjVrSpQ4. Cafflon Ctxmtm Estates ID#t 3711-701-6612-000- St. Lucie County
rnarvemn tXl ITEMS ARE NOT, IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
.TANK INSTALLATION -
[01]
TANK SIZE 1.1 I090.-00 [2]
I
E021.
TA11K MATERIAL Po,[ypropvlene
l031
OUTLET', n9vtot
I
t043
MULTI -CHAMBERED Im N
3
(Q51
quTLST FILTER
[661
It6s1 , 1. 70443-1113G4 2.
1 1
[071
WATERTIGHT
LO81
LEVEL
ro9j
DEPTH TO LID
DRAIHFIELD
INSTALLATION
E 1
[3.01
AREA [1] 6791 12] SQFT
j
t11'7
DtSTRISUTIDN BOX HEWER x
.1
[121
NUMBER OF DRAINLINES j, 6.00 2.
I
j13l
DRAINLINE SEPARATION
I
E141
DmIMprNE; SLOPE
3
L151
DEPTH OF COVER
E -1
LI-01
'ELEVATION [FZ;7w,? BELOW 1101 10.00,
E I
tl7f,
SYSTEbi'LOCATION
f 1
11 , al
"DOSING PUMPS
E I
r I
E191
AGGREGATR SIZE
E 1
[201,
AGGREGATE mxcEssxvx ribig&
AGGREGATF, DEPTH
M7j
SURFACE WATER
85,
fT
12131
DITCHES
[29]
PRIVATE WELLS
86�
—FT
t34l
PUBLIC WELLS
PT
[311
IRRIGATION WELLS
FT
[121^
POTABLE WATER
69
FT,
t331
BUILDING FOUNDATIONS
7
72
E-341
PROPERTT LMMS
100,
FT
p5l,
OTHER
FT
FILLED I HOUND SYSTEM
[361
DRAttWfEfL* COVER.
J371
SHOULDERS.
138]
SLOPES
[39]
STABILIZATION 114712010
ADDITIONAL INFORMATION
[4()] UNOBSTRUCTED AREA
STOEMOV&SR: AMOFF
[4f]
(433 MAINTENANCE AGREEMENT
[44] BUILDING AREA
[45] LOCATION -CONFORMS WITH. SITE Pr.W-
[46] FINAL, SITE :GRADING
FILL EXCAVATION MATERIAL
I
[47]
CONTRACTOR MIC14AEL WSTUHR (ASVT0
1
[221
FILL AMOUNT
1
C-481
OTHER, INFILTRATOR WCM PFLA E , 036 LP
i
L211
FILL TECKTUR9
um
EXCAVATION DEPTH
ABANDONMENT
E2511
AREA REPLACED
]
[491
TANK PUMPED
E I
[26]
REPLACEMENT MATERIAL,
I ]
1501I
TANK ChUbHED SPILLED
Co=entg-.
Comments eXe on,pa go 2.
CHO DATE:
CONSmaucTx0i.; t 13
St,, LUcie CHO DATE: Ili2712019
rimm SYSTEM EFAPPROVED ]/ DISAPPROVED 1:
or, gounda �ywlwrldaDepartm�tMnoal
E���
JEa 101ti.OU oE, Violations oa. Eollwing Pagel
DH 4QI6, OU169 (Obzo�jo:kes a,:, previous qua editions *bich may not be used] Page Z, o-f 3
lincozporatod- 64E-6-003i FAC'
DE
4016, Oa/09 (Obsoleted all previous edIti,.us which, may not be used) Page 2 of 3
Incorporated- 64E-6'.003,• FAC
STATE OF FLORIDA '
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
PERMIT #:56-SF-1929058
APPLICATION #:AP1401015
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1207689
SCANNED
CONSTRUCTION PERMIT FOR: OSTDS New A B
APPLICANT: (RonRaymondConstruction) St. Lucie County
PROPERTY ADDRESS: 17803 Bridle WaV Port Saint Lucie. FL 34987
LOT: 20 BLOCK: 'SUBDIVISION: Carlton Country Estates
PROPERTY ID #: 3211-701-0022-000-0 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAR 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 [
1,050 ] GALLONS / GPD SeDtiC New
CAPACITY
A [
] GALLONS / GPD NIA
CAPACITY
N [
I GALLONS GREASE INTERCEPTOR CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [
] GALLONS DOSING TANK CAPACITY [
]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [
500 ] SQUARE FEET Drainfield New
SYSTEM
R [
I SQUARE FEET N/A
SYSTEM
A TYPE
SYSTEM: [ ] STANDARD [ I FILLED
DO MOUND [ ]
I CONFIGURATION: [XI TRENCH [ ] BED [
]
N
F LOCATION OF BENCHMARK: PROJECT BM SET NAIU TIN
TAB EL=100.00
I ELEVATION OF PROPOSED SYSTEM 'SITE [ 5.00 It INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 1.00 ][ INCHES FT ][ AEOVE BELOW] BENCHMARK/REFERENCE POINT
L
D I
O
T
H
E
R
I" M WwW M V: LZq.VVJ 1NUHGS GXUAV""UN NGYU+!(CL: t J +
The system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated Flow of
400 gpd.
APPROVED BY:
DATE ISSUED
DH 4016, 08/09
Incorporated:
BY: Dianna S May TITLE: Environmental Supervisor I
'7—t-.,-....- �[{@.v/ TITLE: Environmental Supervisor I St. Lucie CHD
Dianna S May
03/19/2019
(Obsoletes all previous editions which
may not be used)
64E-6.003FI L '"-j'
EXPIRATION DATE: 09/19/2020
Page 1 of 3
WGI1. nb . 9:1 - 2�i2'13
q STATE OFFLORIDAERMIT NO. 5Ip-SF— 11g05S
DEPARTMENTT OFF HEALTH DATE PAID: ( (Q
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: #1�.2�Fi
it SYSTEM RECEIPT 616
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[X New System [ ] Existing System [ ] HoldingTank
[ ] Repair [ ] Abandonment [ ] Innovative
[ ] Temporary [ ]
APPLICANT: &/ fit^ l'�Vj.(JP/D
AGENT:(/�iYr/��Ej`,'Ft" AS.L�(fi�E'S //1� TELEPHONE:
MAILING ADDRESS: 07/
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:' 20 BLOCK: SUBDIVISION: CA9L�0^/ Z(�//ilr 14v � PLATTED: Z 05.
PROPERTY ID OUZZONING: I/M OR EQUIVALENT: [ Y / N ]
PROPERTY SIZE:' 1 ACRES WATER SUPPLY: [K] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y N ] DISTANCE TO SEWER:' S,OL+DFT
PROPERTY ADDRESS: Ingo %j'ptnt:-& t.+'ny %�L7w-
r
DIRECTIONS TO PROPERTY: OOLCb rG �hr(�0/✓[ 7?-(jG / y
orb dwGf say 2aw) As��i� /vim �Npt le/L Pr---_�AG OAJ
BUILDING INFORMATION
Unit Type of
No Establishment
[X RESIDENTIAL [ ] COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sq£t Table 1, Chapter 64E-6, PAC
1 �l�lGvye 1MIL Sllwc
2
3
4
Zi) 3o , Per Floor ttin
[ ] Floor/Equipment Drains / [ ] Other (Specify)
SIGNATURE: AAA, �/!
DH 4015, 08/09 (Obsolet
Incorporated 64E-6.001,
DATE: Z/Z^/ Z%
s24re io sl OV-1 n G ®� l p �ich may not
FAC
Page 1 of 4
STATE OF FLORIDA APPLICATION #
DEPARTMENT OF HEALTH PERMIT # 56-SF-1929058
ONSITE SEWAGE TREATMENT AND. DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT If SE1156705
APPLICANT: Ron Raymond Construction
CONTRACTOR / AGENT: Laventure & Associates Inc
LOT: 20
BLOCK:
SUBDIVISION: Carlton Country Estates ID#: 3211-701-0022-000-0
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: [X IYES [ ]NO NET USAELE AREA AVAILABLE: 5.17 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 7754.99 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 80000.00 SQFT
UNOBSTRUCTED AREA REQUIRED: 1000.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: PROJECT BM SET NAIL/ TIN TAB EL=100.00
ELEVATION OF PROPOSED SYSTEM SITE 5.00 [ INCHES / FT I [ ABOVE / E2W11 BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: 75 FT DITCHES/SWALES: 100+ FT NORMALLY WET: [ ]YES [X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 90 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 100+ FT POTABLE WATER LINES: 50 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
SOIL PROFILE INFORMATION STTF. 1
USDA SOIL SERIES:Wabasso
Munsell #/Color
fine sand
Texture
Depth
1 OYR 5/1
Sand
0 To 12
10YR 6/2
Sand
12 To 22
10YR 6/1
Sand
18 To 26
1 OYR 4/4
Sand
26 To 30
10YR 2/1
Sandy Loam
30 To 46
10YR 4/2
Clay Loam
46 To 60
10YR 513
Sand
60 To 72
SOIL. PROFILE INFORMATION SITE 2
USDA SOIL SERIES:Wabasso
Munsell#]Color
fine sand
Texture
Depth
10YR 5/1
Sand
0 TO 15
10YR 6/3
Sand
15 To 20
10YR 6/1
Sand
20 To 28
10YR 4/4
Sand
28 To 33
10YR 2/1
Sandy Loam
33 To 46
10YR 4/2
Clay Loam
46 To 60
1 OYR 6/2
Sand
60 To 72
OBSERVED WATER TABLE: INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 18 INCHES [ ABOVE / FLOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 18.00 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
SWT determined using USDA WSS and soil borings. 10YR6/1 stripping in a 10YR6/2 matrix >10% with diffused boundaries starting
18" in S131.
11= 5" below BM, SB2= 4" below BM.
SITE EVALUATED BY: !!!�+� DATE:
May, Dianna (Title: En ronmentnl Supervisor 1) (Florida Department of Health in St Lu
DH 4015, 08/09 (obsolete. previous editions which may not be used) Inoorp... ted: 64E-6.001, FAC
INCHES
03/12/2019
Page 3 of 4
0�txa
STATE OF FLORIDA
DEPARTMENT OF HEALTH
f ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
��kb K�
PERMIT #. 6G-rF- jq'L1655
APPLICANT: P,41YA 0%JO W/✓,7// 41470'4 AGENT: LAZo\1,Tj-( /y�S(?U/if%&4 t/V �'
n �y�
LOT: Z(i BLOCK:: rJ SUBDIVISION: �s49%C'� aUAOAO y ,5Sr/l io/
PROPERTY ID #:Gl�- !��—�GZ�-QI'X,�{� [Section/Township arcs moo. r Tax ID Number]
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: S:// ACRES
TOTAL ESTIMATED SEWAGE FLOW: GALLONS PER DAY [RESIDENCES -TABLE 1/OTHER-TABLE21
AUTHORIZED SEWAGE FLOW: j GALLONS PER DAY [1500 GPD/ACRE OR 2500 GPD/ACRE]
UNOBSTRUCTED AREA AVAILABLE:), ('�Q .p SQFT UNOBSTRUCTED AREA REQUIRED: 0!�l.S SQFT
BENCHMARK/REFERENCE POINT LOCATION: Mk f'1r-..fL]l� bald �[•l,G // Aa C,X (7P Ltrr
ELEVATION OF PROPOSED SYSTEM SITE IS7 NCHE 0T] [ABOVE ELOW} ENCHMAR�13EFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER:_L5 FT DITCHES/SWALES: /5- FT NORMALLY WET? [ ] YES W NO
WELLS: PUBLIC: 2.00 FT LIMITED USE: ICO FT PRIVATE: 75 FT NON -POTABLE: --50 FT
BUILDING FOUNDATIONS: FT PROPERTY LINES:_j_i_FT POTABLE WATER LINES:> 10 FT
SITE SUBJECT TO FREQUENT .FLOODING: [ ] YES jPq NO 10 YEAR FLOODING? [ ] YES ['l] NO
10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD
SOIL PROFILE INFORMATION SITE 1
MUNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
SOIL PROFILE INFORMATION SITE 2
MUNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
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: ^ /-., G i(
12 Ct/APD C,��/TCP �CaPiIOA /BLS• .SZI
DH 4015, 06/09 (ObsoleteB previous editions which may not be hsed) Incorporated: 64E-6.001,
: Z/27//Z
Page 3 of 4
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.
M—e cation 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.