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HomeMy WebLinkAboutSUBMITTED DOCUMENTSBUILDING PLAN CHECK ST. LUCIE COUNTY -FORT PIERCE FIRE PREVENTION BUREAU FORT PIERCE, FLORIDA 33450 i CONTRACTOR: A141 Co 1 i e ARCHITECT: fR6"11*7P/7 %Amhu BY St. Luciecouoty DATE RECEIVED: Zo _//_;T PHONE NUMBER: ",r- 94 90 PHONE NUMBER: OWNER iY.��t �/y zs� 1.,.. ��s .t/o�i� r,�Al2v~.o LOCATION• Us'0` - Se H, 6AA S;j of Flja_�;e s of Pi.,A zk /vew/ TYPE OF OCCUPANCY: TYPE OF CONSTRUCTION: SIZE OF BUILDING• AY5xo zAcro NUMBER OF FLOORS: ! RECOMMENDATIONS: S8C- REMARKS: REVIEWED BY: ¢ � DATE: /40 7S' Signature 3Y)Idf I]YS - At mNo By B I Y I L Applica e p P r'm 8/1 -5 N T✓ SCAPJNLL, BY STATE OF FLORIDA S4. Lucie d©uo DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES DIVISION OF HEALTH Post Office Box 210, Jacksonville, Florida 32201 APPLICATION AND PERMIT OF INDIVIDUAL SEWAGE DISPOSAL FACILITIES Section I - Instructions: 1. Percolation test data, soil profile and water table ele- vation information must be attached. (Note: Test must be made at proposed location of system). 2. Existing building and proposed buildings on lot must be shown and drawn to scale at their location or proposed location. (Use block on this sheet or attach plot plan). 3. Proposed location of septic tank must be shown on plan. 4. Any pond or stream areas must be indicated on the plan. Section II - Information: St.. Lucie County Health Department 5. Indicate name and date of plat of subdivision. If not platted, attach metes and bounds description. 6. Complete the following information section. NOTES: 1. Not valid if sewer is available. 2. Individual well must be 75 feet from any part of system. 3. Call and give this office a 24-hour notice when ready for inspection. 1. Property Address (Street & House No.) U.S, 1 Lot Block Subdivision Date Platted Directions to Job S. on U" 2. Owner or Builder Anenony A.Lt zt P. O. Address City Septic tank system to be installed by: 3. Specif' tons: d ��� gallon tank with �IZQ� square feet of drainfield with at least 4" inside diameter pipe. 4. House--fo be constructed: Check one: FHA VA Conventional This is to certify that the project described in this application, and as detailed by the plans and speci- fications and attachments will be constructed in ac- cordance with state requirements. I Applicant: An-chonv VeplSignIture:C Section III - Application Ai 0 W 3 0 W THIS PERMIT EXPIRES ONE (1) YEAR FROM ID- T,E 0�0)SSUANCE Sca(Rear) 'act LL.0 ram' A— vi/X��al�I:q�G/BZ/ Permit VOID if well or septic system is installed in a location other than area permitted. PRIOR HEALTH DEPARTMENT ^ ^^"AI_ REQUIRED (Front) (Name of Street or State Road) Date: C� — " ' ' DO NOT WRITE BELOW THIS LINE aroval & Construction Authorization Installation subject to following special conditions: The above signed application has been found to be in compliance with Chapter 1OD-6, Florida Admini rative Code, and c tru I n s hereb approved, subject to the above specifica ' a conditions. By: r County Health Dept. � Date f " i " " • * t M * • * " Y a • a i • i! • • a * a a • • • " • • • • R I Section IV - Final Construction Approval Construction of installation approved: Yes No Date: By: FHA No. VA No. a M • a M * * a * • • • * • • w • • iF a a • a " r" • " w • • • • • " N • • • • w SAN 428 REV. 3/75 O