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HomeMy WebLinkAboutD O H PAPERWORKSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSIT� SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: [ X ]New System [ ]Existing'System ]Repair [ ]Abandonment APPLICANT: Doran, Tony ..PROPERTY STREET -ADDRESS: 703 Ramie Ct ]Holding Tank ]Temporary CENTRAX #: 56-SF-09166 DATE PAID: FEE PAID $ RECEIPT OSTDSNBR 07-00025 -N ] Innovative Other 7 AGENT:ALEXANDER PIAZZA St. Lucie FL 34952 LOT: 16 BLOCK: 22 SUBDIVISION: River Park [Section/Township/Range/Parcel No.] PROPERTY ID #: --- [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E-6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. 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 PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T [ 1500 ]Gallons SEPTIC TANK A [ 0 ]Gallons N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 D R A I N F I E. L � •D MULTI-CHAMBERED/IN SERIES: [Y J MULTI-CHAMBERED/IN SERIES: [Y ] ]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] [ 875 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM [ 0 ]SQUARE FEET SYSTEM TYPE SYSTEM: [ N ]STANDARD [ Y ]FILLED [ N ]MOUND [ N ] CONFIGURATION: [ Y ]TRENCH [ N ]BED [ N ] LOCATION TO BENCHMARK: C/L of Road Center of Lot - Painted "X" ELEVATION OF PROPOSED SYSTEM SITE [ ] [ INCHES ] [ ABOVE] BENCHMARK/REFERENCE POINT BOTTOM OF DRAINFIELD TO BE [ 2.0 ] [ INCHES ] [ BELOW] BENCHMARK/REFERENCE POINT FILL REQUIRED:[ 12.0 ]INCHES EXCAVATION REQUIRED: [ 0.0 ] INCHES ,. OTHEOREMARKS : - 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. Home stubout invert to be 10 inches above benchmark. Sleeve potable water lines within 10 feet of drainfield. Potable water lines may not be installed within 2 ft of drainfield. Nater line -to be completely uncovered for inspection if it is installed on the same side of property as OSTDS` " Excavation waived. •SPECIFICATIONS BY: POLISSKY, JODI .APPROVED BY: Polissky, Jodi DATE ISSUED: 2/14/07 TITLE: TITLE: Environmental- Spec St. Lucie CHD EXPIRATION DATE: 8/14/08 DH 4016, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744-001-4016-0) [ostds_cons 4oi6-i[ Page 1 Of 2 d e �$ G STATE OF FLORIDA PERMIT NO. ' DEPARTMENT OF HEALTH DATE PAID: i �U ) ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: rl 'qK SYSTEM_ RECEIPT #: APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: "[ X ] New System [ ] Existing System [ ] Holding Tank [ ] Repair [ ] AbandonmentTemporary [ 7 Innovative [ ] Temporaa ry [ ] APPLICANT: Tonv Doran AGENT: AZEXdnd2Z' J. P13ZZd PSM, Inc. TELEPHONE: 1-772-340r7270• MAILING ADDRESS: 619 SW Biltmore Street Port St. Lucie, Florida 34983 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 DATE LOT: 16_ BLOCK: 22 SUBDIVISION: River Park Unit 3 PLATTED: 169 'PROPERTY ID #: [Section/Township/Range/Parcel No. ZONING: J PROPERTY SIZE: 0.35 ACRES [Sgft/43560] PROPERTY WATER SUPPLY: . PRIVATE [� PUBLIC PROPERTY STREET ADDRESS: 703 Ramie Court DIRECTIONS TO PROPERTY: SEE BUILDING INFORMATION [ X ] RESIDENTIAL [ ] COMMERCIAL Unit' Type of No No: of ='Building Commercial/Institutional System Design Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6 FAC 11.1 Residential 4 "50 3 [,X ] Garbage Grinders/Disposals [ X ] Spas / Hot Tubs [ ] Floor/Equipment Drains Ultra -low Volume Flush Toilets [ ] Other (Specify) APPLICANT'S SIGNATURE: H C;r. :-/ �:J• DATE: 1-18-07 'DR 4015, 10/97 (Previous Editions May Be Used) / Page 1 of 3 AJP JOB#: 07-0003 I cHE q, STATE OF FLORIDA: CENTRAX #:_56-SF-09166 DEPARTMENT OF HEALTH OSTDSNBR : 07-00025-N 'p ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS APPLICANT: Doran, Tony AGENT: ALEXANDER PIAZZA LOT: 16 BLOCK: 22 SUBDIVISION: River .Park ID#: --- TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, MUST PROVTDF. REGISTRATION NUMBER AND SIGN AND SEAT, EACH PAGF OR OTHER QUALIFIED PERSON. QF SUBMITTAL, COMPT,FTE ENGINEER'S ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.35 ACRES TOTAL ESTIMATED SEWAGE FLOW: 700 GALLONS PER DAY [64E-6, TABLE 11 AUTHORIZED SEWAGE FLOW: 875 GALLONS PER DAY [1500GPD/ACRE OR 2500GPD/ACRE] UNOBSTRUCTED AREA AVAILABLE: 1750 SQFT UNOBSTRUCTED AREA REQUIRED: 1556 SQFT BENCHMARK/REFERENCE POINT LOCATION: C/L of Road Center of Lot - Painted "X" ELEVATION OF PROPOSED SYSTEM SITE IS 4.00 [ INCHES ] [ ABOVE ]BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER: 80 FT DITCHES/SWALES: 15 FT NORMALLY WET? [ ]YES [ X ]NO WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: N/A FT NON -POTABLE: 50+ FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 10 FT POTABLE WATER LINES: 10 FT SITE SUBJECT TO FREQUENT FLOODING: [ ]YES [ X ]NO 10 YEAR FLOODING? [ ]YES [ X ]NO 10 YEAR FLOOD ELEVATION FOR SITE: 0 FT NGVD .SITE ELEVATION: 0 FT NGVD SOIL PROFILE INFORMATION SITE 1 Munsell #/Color Texture Depth 1OVR-4/1-n (_V Fino Sanri 0 to iFi 10YR-4/9-RN Fine Annri it to 99' 10VR-5/4-V RN Fine Rand 99 to 54 10YR-S/4-V RN T.nnmv Rnnd 54 to 64 10UR-7/9-V P RN Sanr9' 64 to 79 to Vf to to USDA=$OIL SERIES: 30 Pendarvis-Ur SOIL PROFILE INFORMATION SITE 2 Munsell #/Color Texture Depth TOVR-4/1-n RV Finc and 0 to iR 1 OVR-4/7-RN Fine Annri 1R to 94 1 OYR-S/4-V RN Fi no 'Aanri 94 to 54 10YR-5/4-V RN T.namy RanrJ 54 to 66 IOYR-7/3-V P BN Ranri rr to to to to USDA SOIL SERIES: 30 Pendarvis-Ur OBSERVED"WATER TABLE: 57.00 INCHES [ BELOW ] EXISTING GRADE TYPE: [ APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION:30.00 INCHES [ BELOW ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: 0.0 INCHES SOJL TEXTURE/LOADING-RATE FOR SYSTEM SIZING:Fine Sand/0.90 DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: [ X ]TRENCH [ ]BED [ ]OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA: Estimated WSWT determined from USDA Soil Conservation Svc soil survey of SLC S existing Bak elevations of surrounding properties. 11 0.0 INCHES SITE EVALUATED BY: JODI POLISSKY DATE: 2/13/06 TH 4015i 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744-003-4015-1) [ostds-eval_4015-3] _ - Page 3 of 3 9 STATE OF FLORIDA E DEPARTMENT OF HEALTH p ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS APPLICANT: To Doran AGENT: Alexander J. LOT: , 16 BLOCK: 22 SUBDIVISION: River Park Unit 3 PROPERTY ID #: PERMIT #. [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: [ X ] YES [ ] NO NET USABLE AREA AVAILABLE: 0.35 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [RESIDENCES -TABLE 1/OTHER-TABLE21 AUTHORIZED SEWAGE FLOW: GALLONS PER DAY [1500 GPD/ACRE OR 2500 GPD/ACRE] UNOBSTRUCTED AREA AVAILABLE: 900 +\- SQFT UNOBSTRUCTED AREA REQUIRED: SQFT BENCHMARK/REFERENCE POINT LOCATION: Centerline of road at midpoint of lot ELEVATION OF PROPOSED SYSTEM 'SITE IS 8 [INCHES/FT] [ABOVE/BELOW] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: 100 FT DITCHES/SWALES: 15 FT NORMALLY WET? [ ] YES [ X ] NO WELLS: PUBLIC: 200 FT LIMITED USE: 100 FT PRIVATE: 75 FT NON -POTABLE: 50 FT BUILDING FOUNDATIONS: 7 FT PROPERTY LINES: 11 FT POTABLE WATER LINES: 100 FT :r SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ X ] NO 100 YEAR FLOODING? [ ] YES [X] NO 100 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: - - MUNSELL #/COLOR TEXTURE DEPTH TO TO TO TO TO TO TO TO TO USDA SOIL SERIES: OBSERVED WATER TABLE: 40+- 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: [X] TRENCH [ ] BED [ ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA: SITE EVALUATED BY: � nH 40115, -10/96 (Aepfaces HRS-H Foo= 4015 1page 31 which may be used) -DATE: 1-18-07 ". �� Page 3 of 3 AJP JOB#: 07-0003 & STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [.X _] New System [ ] Existing System [ ] -Repair [ ] Abandonment APPLICANT: Tonv Doran PERMIT NO. DATE PAID: FEE PAID: RECEIPT #: - [ ] Holding Tank [ ] Innovative [ ] Temporary [ ] AGENT: Alexander J. Piazza PSM, Inc. TELEPHONE: 1-772-340-7770 MAILING ADDRESS: 619 SW Biltmore Street. Port St. Lucie. Florida 34983 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 DATE LOT: 16 BLOCK: 22 SUBDIVISION: River Park Unit 3 PLATTED: 169 PROPERTY ID #: [Section/Township/Range/Parcel No.] ZONING: PROPERTY SIZE: 0.35 ACRES [Sgft/43560] PROPERTY STREET ADDRESS: 703 Ramie Court DIRECTIONS TO PROPERTY: SEE MAP BUILDING INFORMATION Unit No 1 2 Type.of Establishment PROPERTY WATER SUPPLY: [X] PRIVATE [ ] PUBLIC [ X ] RESIDENTIAL [ ] COMMERCIAL No. of Building Commercial/Institutional System Design Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC Residential 4 5000 3 4 [iX ]'Garbage Grinders/Disposals [ X ] Spas / Hot Tubs [ _[ ] Ultra -low Volume Flush Toilets ue[ ] Other (Specify) APPT.ICANT'S SIGNATURE: DHt4015, 10/97 (Previous Editions May Be Used) AJP JOB#: 07-0003 ] Floor/Equipment Drains DATE: 1-18-07- - Page 1 of 3 SEE MAP,NOS. 60&61 t sr I�IFI II \\ g AC"ST Z Oo-aa _ �`<- ERROS21 - �O EMENT NOJ EM Og Q 0 HE) .PARK MELTON� ' OR�I ANITA ¢ m 3 ¢ ¢ ¢ c ¢ IYE 0 MALLWODO AVE BACK fl0 m N CORY CAMPBELL RD :R flIDG GOPHEfl HNL RO GOPHER AV L� HOWARO ST � KEARNEY RD aUl KEY E BB T OR I \ , Q n Esr SFALE ONCNP ©�INRO P IN IANRVE E T o TUPELO T ANDY B Tr -"HEM6W Y R x STEW White I OCA CNICA Cr THANES o flU� City 2 SANOFLY CT?, DOT RI SAVANNAH ST V 1,.. ULRICH BO a. is ON EROSA EM'CE 11 I i 2 t0 Np 9 L0OB 3498AN SUNSHINE OLA iEll PEP rA pC' ,.- I BAflTOW ST o I 5 NOLE AETNA BLVO 6 CLEVELAN PETIT OAS u� s o IDAN1T�lm Z a Vl jai f 6 m U y ¢ F y U m m - i DL S a m EASYST ST _ AWC m ..� 3 C o DENNISON �- - - -- - - V I GOFORTH TTHEDLANDS RD 1ST. LUCLE�N RD I SQUARE I I - WOODLANDS R 115 SHOPPLV0 14 ON PORT SCr LUCIE EvuN I CELV7A � ENI a4 1LE GTOY - •14 OIANE�i1S NOBUfl TEN ¢ i-LfIE ( , -OR .- _. R. I t x DER x F MC(IUILLEN� ROp OCONUT AVE--JCE VIS�;s� —9 34952 J S• ?oy p t� TILTON fl0 9 - `J```• lb_o\CV W.OAi�r. 4 I oa 23 ( STATE OF FLORIDA PERMIT #. DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS APPLICANT: Tony Doran AGENT LOT: 16 BLOCK: 22 PROPERTY ID #: J. Piazza PSM. Inc. .SUBDIVISION: River Park Unit 3 [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 TOTAL ESTIMATED SEWAGE FLOW: _ AUTHORIZED SEWAGE FLOW: _ UNOBSTRUCTED AREA AVAILABLE: PLAN: [ X ] 300 •4O . YES [ ] NO NET USABLE AREA AVAILABLE: 0.35 ACRES GALLONS PER DAY [RESIDENCES -TABLE 1/OTHER-TABLE21 GALLONS PER DAY [1500 GPD/ACRE OR 2500 GPD/ACRE] SQFT UNOBSTRUCTED AREA REQUIRED: SQFT BENCHMARK/REFERENCE POINT LOCATION: Centerline of road at midpoint of lot ELEVATION OF PROPOSED SYSTEM SITE IS 8 [INCHES/FT] [ABOVE/BELOW] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: 100 FT DITCHES/SWALES: 15 FT NORMALLY WET? [ ] YES [ X ] NO WELLS: PUBLIC: 200 FT LIMITED USE: 100 FT PRIVATE: 75 FT NON -POTABLE: 50 FT BUILDING FOUNDATIONS: 7 FT PROPERTY LINES: 11 FT POTABLE WATER LINES: 100 FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ X ] NO 100 YEAR FLOODING? [ ] YES [X] NO 100 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD bu1L e2ubl1 1NtlUAMA'11VN 51'1'N.' 1 MUNSELL #/COLOR TEXTURE DEPTH TO TO TO TO TO TO 1V TO TO USDA SOIL SERIES: �-*acdlJ:Ci]aF0ps!$Z Me) Z43P.VMKS]ZM&P414DWJ MUNSELL #/COLOR TEXTURE DEPTH TO TO TO TO TO TO TO TO TO USDA SOIL SERIES: OBSERVED WATER TABLE: 40+ 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: 'pRAINFIELD CONFIGURATION: [X] TRENCH [ ] FEMARKS/ADDITIONAL CRITERIA: _SITiF EVALUATED BY: DH �15, 10/96 (Replaces HRS-H 4015 [page 3] BED may be used) _ DEPTH OF EXCAVATION: OTHER (SPECIFY) INCHES DATE: 1-18-07 Page 3 of 3 AJP JOB#: 07-0003