No preview available
HomeMy WebLinkAboutD O H PAPERWORKRECENED 0� :s os STATE OF FLORIDA MAY 0 2 2010 y DEPARTMENT OF HEALTH �%p ONSITE SEWAGE TREATMENT AND QX00QW rtMent �' SYSTEM St. Lucie County �`°°°' APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: PERMIT NO. SG^SF IS�-0�4a$ DATE PAID: FEE PAID: 3S RECEIPT #: [ ] New System [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ j] Abandonment [ ] Temporary [ J ] Plan Review APPLICANT:�J�A+(r`F AGENT: ["\�Pi\(1\�C..Vli4����J TELEPHONE MAILING ADDRESS: J. 0-5 �c , 1r1� 3495 ) 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. aaacacccvccccccvvvccccccaavvcvcccccccccccaaccacacvvecvcccacvcvcvcvcavvavvvvccacccvvccvcccc PROPERTY (INFORMATION 1 _ 1 -, `_� my LOT: 1 CJ BLOCCKKA L20 SU/B�DIVISION:��pQ�.+pY-G CXS •�� PLATTED: PROPERTY ID #: //V5^0X" 66-oIoo,-tc JZZONING: R-5-A I/M OR EQUIVALENT: [ Y/ VD ] PROPERTY SIZE: Wart ACRES WATER SUPPLY: [V ] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? I Y/© ] DISTANCE TO SEWER: I FT lr PROPERTY ADDRESS: " , 1 i�Zr C� 1�1� �I • T C�'CL T 4 ✓q•A " —ten DIRECTIONS TO PROPERTY: SCANNED BY St I Idef�n::nh� BUILDING INFORMATION [RESIDENTIAL [ ] COMMERCIAL . Unit Type of No. of No Establishment Bedrooms 1 IbF ?I 2 3 4 Building Commercial/Institutional System Design Area Sqft Table 1, Chapter 6/4E'-6, FAC qa a h/D l3adriapq P!{�^/fS /_ . I+a,50 (�nroork [ ] Floor/Equipmen ra s [ ] Other (Specify) Ii.,ln SIGNATURE: DH 4015, 08/09 �dYoltetes previous editions which may not be used) Incorporated 64E-6.001, FAC DATE: 4//3o lie_ Page 1 of 4 i�,i' Rick Scott Mission: -.i +�+;! a Governor To prated, promote Wnp uvethe health of all people in Horidativough integrated RovZ H Celeste Philip, MD, MP state, efforts. HEALTH Sate Surgeon General and y Vision: To be fhe Healthiest Sate in the Nation May 02, 2018 Mealnie Bullers 5501 Winter Garden Parkway Fort Pierce, FL 34951 RE: Modification to a Single Family Residence - No Bedroom Addition Application Document Number: AP1342055 Centrax Permit Number: 56-SF-1843498 5503 Winter Garden Parkway Fort Pierce, FL 34951 Lot: 18 Block: 160 Subdivision: Lakewood Park Dear Applicant, RECEIVED SCANNED MAY 0 2 7018 St. Lucie County permitting Department St. Lucie Countv This will acknowledge receipt of a floor plan and site plan on 04/30/2018 for the use of the existing onsite sewage treatment and disposal system located on the above referenced property. No objection letter issued for enclosure of carport 5/2/2018. This office has reviewed and verified the floor plan and site plan you submitted, for the proposed remodeling addition or modification to your single-family home. Based on the information you provided, the Health Department concludes that the proposed remodeling addition or modification is not adding a bedroom and that it does not appear to cover any part of the existing system or encroach on the required setback or unobstructed area. No existing system inspection or evaluation and assessment, or modification, replacement, or upgrade authorization is required. Because an inspection or evaluation of the existing septic system was not conducted, the Department cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use. You may request a voluntary inspection and assessment of your system from a licensed septic tank contractor or plumber, or a person certified under section 381.0101, Florida Statutes. If you have any questions, please call our office at (772) 873-4931. Sincerely, liar, Dianna May Environmental Specialist I Department of Health in St. Lucie County Pbd" D.P m "t of ReaM w AorlENultl,.yav In St. Lucie County • 5150 NW Milner Drive • Port Saint Lucie, Florida TWITTER:HealthyFLA 34983 FACESOOK:FLDepartmentofHealth PHONE: (772) 873-4931 1 YOUTUBE: fldoh Yage 1 of 1 �)foQQ�+y� SCANNED `Jc4}iG BY St. Lucie County °0 �x C 4i�R ill k puss .�` r�� r rr rz'•+r,l ��a r x}�y.� yy� Y � u sy"sh r°`i s U� 9A�ha'` •'Ar n A,! I S. ��` uJ � 5 T �, � ��� �'�F� i$•a s.�TJ 9¢' � a � k� s W� y + � a I 5 ,i 'fir wN'���v�•i l�Phi����S n�saj,�v �� �i���?� `� I �3 t i FDOH in St. Lucie County Environmental Health Septic System Appears Adequate A41. T For Proposed Construction 5Z-Sf-18434g8 This Approval Does Not Guarantee (�' 3 Performance of the System Reviewer: 'XA& -- ?�tt J httn•/hxnv ni acln nro/imaoPCkatchaciskrirth/i/t57f 1674 1 ino 4/10/2n1 R RECEIVED St. Lucie County Health Department MAY 0 2 2018 5150 NW Milner Dr Port Saint Lucie, FL 34983 HEALTH Permitting Department St. Lucie County PAYING ON: PERMITM56-SF-1843498 BILL Doca:56-BID-3730071 CONSTRUCTION APPLICATION #:AP1342056 RECEIVED FROM: Mealnie Bullers AMOUNT PAID: $ 35.00 PAYMENT FORM: CREDIT CARD PAYMENT DATE: 04/3012018 MAIL TO: Jack & Melanie Bullers SCANNED BY St. Lucie County FACILITY NAME: PROPERTY LOCATION: 5503 Winter Garden Pkwy Fort Pierce, FL 34951 18 Lot: Property ID: 1301-614-0108-000-9 160 Block: EXPLANATION or DESCRIPTION: QUANTITY 139 - OSTDS Application Approval Existing, No Insp 1 $ RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-3528482 FEE 35.00