The URL can be used to link to this page

Home My WebLink AboutDOH PAPERWORKSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM St. Lucie Cowaiy CONSTRUCTION PERMIT FOR: OSTDS New PERMIT #:56-SF-1940854 APPLICATION #:AP1408687 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1213301 APPLICANT: (Wade Journey Home) PROPERTY ADDRESS: 5305 Hummingbird Way, "Fort Pierce, FL 34951 LOT: 15 BLOCK: 12-' 'SUBDIVISION: Lakewood Parg [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] PROPERTY ID #: 1301-602-0041-000-4- [OR TAR ID NUMBER] SYSTEM MUST BE CONSTRUCTED 'IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 391.0065, F.S., AND CHAPTER 64E-6, E.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 Septic new 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 [ 500 ] SQUARE* FEET Dralnfield new SYSTEM R [ ] SQUARE. FEET,,. N/A SYSTEM A TYPE SYSTEM: [.:] 'STANDARD [ ] FILLED rA] MOUND [ ] - I CONFIGURATION i' [x] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARi" Site BM 1 set PK nail elev 20.38 I ELEVATION OF PROPOSED SYSTEM SITE [ 1.00 ][ INCHES FT I ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 1.00 ][ INCHES FT ][ ABOVE BELOW] BENCHMARK/REFERENCE POINT L '0 0 T H E R FILL REQUIRED: [ZU:UU] INCHES EXCAVATION REQUIRED: H 4L.VUJ lvu=b The system is sized for 4 ;Dedrooms'w[th a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of 400 gpd. n ep� SPECLFLCATIONS BY: _ ,grian JI;ngu y �- TITLE: Environmental Specialist II APPROVED BY: - LE.:.Environmental Specialist II St. Lucie CHID .... . Htan'S In . DATE ISSUED: 04/23/2019- EXPIRATION DATE: 10/23/2020 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 AP1408687 SE1162912 0 l %, 4 -Q cc->"� 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. 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. I®6 B a HEALTH PAYING ON: RECEIVED FROM: PAYMENT FORM: St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 a: 56-SF-1940854 SILL Doc a:56-BID-4136888 CONSTRUCTION APPLICATION #: AP1408687 Wade Jurney Homes, LLC AMOUNT PAID: $ 515.00 CHECK 30112 PAYMENT DATE: 04/12/2019 MAIL TO: (Wade Journey Home) FACILITY NAME: PROPERTY LOCATION: 5305 Hummingbird Way Fort Pierce, FL 34951 Lot: 15 Block: 12 Property ID: 1301-602-0041-0004 EXPLANATION or DESCRIPTION: 128 - OSTDS Construction System Inspection Research Fee -1 - Surcharge (All) -1 - OSTDS New Permit Surcharge -1 - OSTDS Construction Application and Plan Review,New 123 - OSTDS Construction Site Evaluation , 126 - OSTDS Construction Permit (New or Mod, Amendment) 127 - OSTDS Construction System Inspection 133 - OSTDS Construction Reinspection QUANTITY FEE 1 $ 5.00 1 $ 15.00 1 $ 100.00 1 $ 100.00 1 $ 115.00 1 $ 55.00 1 $ 75.00 1 $ 50.00 RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-3901353 Note: paid for well too. total $630 y�'nre'T,r WL[( 5C1-Zq'417 STATE OF 'FLORIDA PERMIT NO. qF -19'i0&Sy %Sf DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: (g 2A) SYSTEM. RECEIPT APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [ V'] New System [ ] Existing System C ] Holding Tank [ ] Inmoygtive ' [ I Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT: AGENT: � �'•V��l�/j`�� C i TELEPHONE: ,�^ q -j L{,L17 NAILING ADDRESS: l t . I C) -S r"�- ' L� �'�i U C..:J \ ' .f -L 3 431-`] i J TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHVRTZED AGENT SYSTEMS 14UST 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/YT) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS, PROPERTY INFORMATION LOT: ��, BLOCK: p� SUBDIVISION: �CL\ PLATTED: PROPERTY ID #; _13C�`-(�C �. —CX"i i'�-G(:b ZONING: I/M OR EQUIVALENT: [ Y/h( ] PROPERTY SIZE: 119 ACRES WATER SUPPLY: [XI PRIVATE PUBLIC [ ].<=2000GPD [ 1.>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ YA[1] PROPERTY ADDRESS: DIRECTIONS TO PROP DISTANCE TO SEWER: 5_FT BUILDING INFORMATION [x] RESIDENTIAL [ ] COMMERCIAL Unit Type of No. of Building Commercial/Institutional System Design NO Establishment Bedrooms Area Sqft Table 1,, Chapter 64E-6, FAC I /Iao 2 3 4 [ 7 Floor/Equipment Drains [ ] Other (Specify) DH 4011, 08/09 (Obsoletes previous,editrons which may not be used) Incorporated 64E-6.001, VAC DATE: `L( I (CA (1 Page 1 of 4 STATE OF FLORIDA APPLICATION # AP1408687 DEPARTMENT OF HEALTH PERMIT # 56-SF-1940854 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE1162912 SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: Wade Journey Home CONTRACTOR / AGENT: Wade Jumey Homes LLC LOT: 15 BLOCK: 12 SUBDIVISION: Lakewood Park ID#: 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]YES [ ]NO NET USABLE AREA AVAILABLE: 0.27 ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 404.99 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 1000.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: Site BM 1 set PK nail eleV 20.38 ELEVATION OF PROPOSED SYSTEM SITE 1.00 [[INCHES / FT ] [ ABOVE / EiOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES/SWALES: 15 FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 95 FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 30 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]N01 10 YEAR FLOOD ELEVATION FOR SITE: FT [ MSL / NGVD ]- SITE ELEVATION: FT [ MSL / NGVD SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES:Wabasso Sand Munsell #/Color Texture Depth 10YR 4/1 Sand 0 To 11 1 OYR 5/1 Sand 11 To 19 1 OYR 6/1 Sand 19 To 30 10YR 7/1 Sand 22 To 30 1 OYR 211 Spodic Material 30 To 41 1 OYR 5/3 Sandy Loam 41 To 60 10YR 5/3 Loamy Sand 60 To 72 USDA SOIL SERIES:Wabasso sand Munsell #/Color Texture Depth 1 OYR 4/1 Sand 0 To 12 1 OYR 511 Sand 12 To 27 10YR 6/1 Sand 23 To 33 I OYR 2/1 Spodic Material 33 To 42 1 OYR 5/2 Sandy Loam - 42 To 55 10YR 5/2 Loamy Sand 55 To 72 OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / HELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 22 INCHES [ ABOVE / HELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 22.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: 42 INCHES DRAINFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY) r REMARNS/ADDITIONAL CRITERIA VT determined using USDA WSS and soil borings. t611 stripping in 10YR N matrix >10% with diffuse boundaries starting at 22" In SB1. and SB21" below BM. _ 1�1 SITE -EVALUATED BY: / �C__e Ingram, Brian (Title: DR 4015, 08/09 (Obsoletes previous editions which 'V:_—� DATE: 04/16/2019 ronmental Specialist II) (ENVIRONMENTAL HEALTH) not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 AP140BG87 EID1940864 v 1.0.2 JOSEPH E- SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY FILE # 4497601 OR BOOR 4198 PAGE 2150, Recorded 11/01/2018 04:28:05 PM Doc Tax: $77.00 5'6-Sr- jc yg6?5V Prepared by and return to. Annette Giardina Haber Attorney at Law Jones, Haber&Railings 1633 Southeast 47th Terrace Cape Coral, FL 33904 239-542-0700 File Number: 41452 (Spam above This Line ForkeWIding DAW Warranty Deed This Warranty Deed made this re -11 ,day of October, 2018 between William T. Hudson, Ill, an unmarried man whose post office address is 18 Orangeblossom Trail, Yataha, FL 34797, grantor, and WJH LLC„ a Delaware limited liability company autharized to transact hoslaess as a foreign limited liability company In Florida ns WJHFL, LLC., a Florida Foreign limited liability company whose post office address is 3300 Battleground Avenue, Ste, IN, Greensboro, NC 27410, granice: (Wbomr used herein the lema'greoe f and -voice include no the parties to this insm m at. and the hfirs, legal representatives, and assigat or individuals, and the successor, and aV igns oCmrpameans, tmals and Wsims) Witrlesseth, that said grantor, for and in considemtion of the sum of TEN AND NGII00 DOLLARS ($10.00) and other good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged, has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land situate, lying and being in Saint Lucie County, Florida to -wit: Lot 15, Block 12, Lakewood Perk Unit No. 2, according to the map or plat thereof, as recorded In Plat Book 10, Page(s) 5Cand 56A through 56C, of the Public Records of St. Lucie County, Florida. Parcel Identification Number: 1301.602-0041.000-4 Together with all the tenements, bereditamenis and appurtenances thereto belonging or in anywise appertaining. To Have and to Hold, the same in fee simple forever. And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor has good right and lawful authority to sell and convey said land; that the grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever, and that said land is free of all encumbrances, except taxes accruing subsequent to December 31, 2011. In Witness W hereof, grantor has hereunto set gmnfor's hand and seal the day and year first above written. i' ncd, sealed elivered in our presence: Wlln Name: C v 5 Witness Name: aAF� ,IAS State of Florid County of�__ A11 `1,�/ (Sano l ` - William TT H udsol III The foregoing Instrument was acknowledged before me this G7 "'day of October, 2018 by William T Hudson, 111, who Lj is personally known or [X] has produced a driver's license as (dentiflqtition. [Notary Seal] now nintel l• NaarYPuMk • bntr aI flal4a �f 'eamltdulan#FF954541 !"t.- ':,"' try Comm. Fxgro4 arp 17, 2a2i Printed Name: Commission Expires: 0aubtaTima w rig 4 s�'4 r 3t`�L✓1-- r �n Custom Soil Resource Report St. Lucie County, Florida 48—Wabasso sand, 0 to 2 percent slopes Map Unit Setting _National map unit symbol: 2svyr Elevation: 0 to 70 feet Mean annual precipitation: 46 to 55 inches Mean annual,air temperature: 70 to 77 degrees F —Frost-free period.-355 to 365 days Farmland classification: Farmland of unique importance Map Unit Composition Wabasso and similar soils: 85 percent Minor components: 15 percent Estimates are based on observations, descriptions, and transacts of the mapunit. Description of Wabasso_ Setting, Landform: Flatwoods on marine terraces Landform position (three-dimensional): Tread, talf Down -slope shape: Linear Across -slope shape: Linear Parent material. Sandy and loamy marine deposits Typical profile A - 0 to 6 inches: sand E - 6 to 25 inches: sand Bh - 25 to 30 inches: sand Btg - 30 to 58 inches: sandy clay loam Cg - 58 to 80 inches: loamy sand Properties and qualities Slope: 0 to 2 percent Depth to restrictive feature: 9 to 50 inches to strongly contrasting textural stratification Natural drainage class: Poorly drained Runoff class: Very high Capacity of the most limiting layer to transmit water (Ksat): Moderately low to moderately high (0.06 to 0.20 in/hr) Depth to water table: About 6 to 18 inches Frequency of flooding: None Frequency of ponding: None Calcium carbonate, maximum in profile: 5 percent Salinity, maximum in profile: Nonsaline to very slightly saline (0.0 to 2.0 mmhos/cm) Sodium adsorption ratio, maximum in profile: 4.0 Available water storage in profile: Very low (about 1.4 inches) Interpretive groups Land capability classification (irrigated): None specified Land capability classification (nonirrigated): 3w Hydrologic Soil Group: CID 10 Custom Soil Resource Report Forage suitability group: Sandy soils on flats of mesic or hydric lowlands (G155XB141FL) Other vegetative classification: South Florida Flatwoods (R155XY003FL) Hydric soil rating: No Minor Components Hallandale Percent of map unit: 6 percent Landform: Flatwoods on marine terraces Landform-position (three-dimensional): -Tread, tall - - Down -slope shape: Linear Across -slope shape: Linear Other vegetative classification: South Florida Flatwoods (R155XY003FL) Hydric soil rating: Yes Boca Percent of map unit 5 percent Landform: Drainageways on marine terraces, flats on marine terraces Landform position (three-dimensional): Tread, dip, tall Down -slope shape: Linear, convex Across -slope shape: Linear, concave Ecological site: South Florida Flatwoods (R155XY003FL) Other vegetative classification: South Florida Flatwoods (R155XY003FL) Hydric soil rating: Yes Pineda Percent of map unit: 4 percent Landform: Drainageways on marine terraces, flats on marine terraces Landform position (three-dimensional): Tread, dip, talf Down -slope shape: Linear Across -slope shape: Concave, linear Othervegetative classification: Slough (R155XY011FL) Hydric soil rating: Yes 11 Mission: To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. yk14FYY ,6v HEALTH Vision: To be the Healthiest State h the Nation Florida Department of Health in St. Lucie County Conditions for Issuance of Water Well Permits Effective July 24, 2017 Ron DeSantis Governor • Contact the Florida Department of Health in Saint Lucie County (FDOH — St. Lucie) prior to constructing or abandoning any well. a. Call the FDOH — St. Lucie Well Line at 772-873-4936 or email SLCDOH-WELLS(cDFLHEALTH.GOV b. Provide the following information: i. Permit number ii. Driller name iii. Address iv. Date and time to begin construction/abandonment • A minimum of 24 hours'.notice is required before constructing any public water supply wells. Please call our main office at 772-873-4931 and speak,with Environmental Health Staff or provide notification by email to SLCDOH-WELLSCcDFLHEALTH.GOV • Submit revisions to permit and/or site map and associated fee within 48 hours of well construction or abandonment. Florida Department of Health St Lucie County • Division of Disease Control and Health Protection Bureau of Environmental Health 5150 NW Milner Drive Plod St Lucie, FL 34983 PHONE: 7721873-4931 • FAX: 772/595-1306 FloridaHealth.gov Accredited Health Department Public Health Accreditation Board STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT, REPAIR, MODIFY, OR ABANDON A WELL Permit No. 59-29417 ❑ Southwest PLEASE FILL OUT ALL APPLICABLE FIELDS Florida Unique ID ❑ Northwest ('Denotes Required Fields Where Applicable) Permit Stipulations Required (See Attached) ❑ St. Johns River [a South Florida Theoaterwelicontroaorisrespnnsiblelorcomplefln9 ❑Suwannee River this formand fommrding thepermimpplication to the opproydNcdeleyoledouthoritywhereapPH[ahk. 62-524 Quad No. Delineation No. ❑ DEP CUPNW P Application No. ❑ Delegated Authority (If Applicable) 1. WJH, LLC 3300 Battleground Avenue, Suite 230 Greensboro,NC 27410-2490 772-453-4143 *Ovmer, Legal Name if Corporation *Address *City *State *ZIP Telephone Number 2.5305 Hummingbird Way Fort Pierce FL 'Well Location -Address, Road Name or Plumber, City 3.1301-602-0041-000-4 15 12 2 —*Parcel IDNo. (PIN) or Alternate Key (Circle One) Lot Block Unit 4.11 34S 39E St Lucie Lakewood Park Check if 62-524:❑ Yes ❑ No *Section or Land Grant *Township *Range *County Subdivision 5. SCOWS Drilling, Inc. 11213 772-489-6117 scottsdrilling@bellsouth.net 'Water Well Contractor *License Number *Telephone Number E-mail Address 6.5014 Palm Drive Fort Pierce FL 34982 'Water Well Contractor's Address City State ZIP 7. *Type of Work: ❑✓ Construction ❑ Repair ❑ Modification❑ Abandonment 8. *Number of Proposed Wells ONE 'Reason for Repair. Modificaficn.or Abandonment 9. *Specify Intended Use(s) of Well(s): ��%J� e Domestic Landscape Irrigation Agricultural Irrigation Site Investigations v L Bottled Water Supply ®Recreation Area Irrigation H Livestock H Monitoring ] Public Water Supply (Limited Use/DOH) ❑ Nursery Irrigation ❑ Test ] Public Water Supply(Community or Non-Community/DEP)❑ Commercial/Industrial Earth -Coupled Geothermal APR 2 3 2019 ] Class I Injection ❑ Golf Course Irrigation HVAC Supply HVAC Return 'lass V Injection: ❑ Recharge ❑ Commercial/Industrial Disposal ❑ Aquifer Storage and Recovery ❑ Drainage ON to St Lude Comb 2emediation: ❑ Recovery ❑ Air Sparge ❑ Other (Desanbe) E*, IRONMEIMUNEALi Other (oesvibe) 10.*Distance from Septic System if <_ 200 ft. 10 11. Facility Descriptionsingie Tarnuy resltaence 12. Estimated Start Date 13.'Estimated Well Depth 120 ft. *Estimated Casing Depth 100 ft. Primary Casing Diameter 2 in. Open Hale: From _To _ft. '14. Estimated Screen Interval: From 100 To 120 ft. 15.*Pdmary Casing Material: Black Steel Galvanized PVC •' Stainless Steel Not Cased Other: 15. Secondary Casing: Telescope Casing Liner Surface Casing Diameter in. 17. Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel Other 18.*Method of Construction, Repair, or Abandonment: Auger Cable Tool Jetted ,r Rotary Sonic Combination (Two or More Methods) Hand Driven (Well Point, Sand Point) Hydrau Ic oinl (Direct Push) Horizontal Drilling Plugged by Approved Method, Other (oesanbe) 19. Proposed Grouting Interval for the Primary, Secondary, and Addi' nal-easing: From o To 100 Seal Material ( Bentonit Neat Cement' Other ) From To Seal Material ( Bentonite a -ement Other ) From To Seal Material ( Bentonite Neat Cement Other ) From To Seal Material ( Bentonite Neat Cement Other ) 20. Indicate total number of existing wells on site 0 List number of existing unused wells on site 0 21.'Is this well or any existing, well or water wilibemwafon the owner's contiguous property covered under a ConsumptiveM/ater Use Permit (CUPANUP) or CUPM/UP Application. Yes/' ✓ NN�yes, complete the following: CUPM/UP No. District Well ID No. 22. Latitude Longitude 23. Data Obtained From: GPS Map Survey Datum: _NAD 27 _NAD 83 _WGS 84 M1crebyceNry Nat l ea mn+plyvA Na appff.bl. On er 70v 40. nvoa Md rslradve Cad,. and Nat a Inter Icmlry Natl ern Nv owner of Nep+oput,%.,,N,NW.,,1oo previhd N an'mnle. and Nat l inn ayse dmy scperdtoreN6dal.crarw nerdl. itreod.d. has been q A be cbiaaed odor to eammmxmmt ofwea re,s oeaifks.,drV\.at. r373. Fle dch 9abeea. to niwntam m wenedv eE.&. No vr,L or. l uWN Nat l am �"— - 11213 \ c• �ci 'Signature of Contractor -License No. 'Signature of Owner or Agent °Cattle Approval Granted By Issue DateWIMIA T Expiration Date Hydrologist Approval Nitlals Fee Received S 10pecallat No. Chock No. THIS PERMIT IS NOT VALID UNTIL PROPERLY SIGNED BY AN AUTHORIZED OFFICER OR REPRESENTATIVE OF THE IAMD OR DELEGATED AUTHORITY. THE PERMIT SHALL BE AVAILABLE AT THE WELL SITE DURING ALL CONSTRUCTION, REPAIR, MODIFICATION, OR ABANDONMENT ACTIVITIES. BOUNDARY SURVEY OF LOT 15, BLOCK 12, LAKEW000 PARK, UNIT NO. 2, according to the plot thereof as recorded in Plat Book 10, Poge(s) 56 through 56C, of the Public Records of St. Lucie County, Florida. (Contains 0.27 acres) im iWELL 1 / WELL EDEN ROAD AT PI (70' PUBLIC R 7 W _ \ LOT \ / i 14�� BLOCK 12 \ 3y� a m V RESIDENCE\ FF=21.91 a?N FIR / R'F1/2 ' FENCE;GAER UNABLE TO LOCATE SEPTIC PENCE CORNER 8 ` M m m 5.00'E. OA., 8.3'E , n , S 89 47 52 E 133.13 . 0.2N. 20.75 FIR 1/2' , 35 nn' 20.151 0 .49 SET BENK NAIL 1 LOT 6 & 7 (DOUBLE LOT) BLOCK 12 O I RESIDENCE b� W V 4, o mV as 04 r c o CD Ii 20.52 LOT 5 BLOCK 12 aau c.-;> RESIDENCE /I- \ SEPTIC OUT OF RANGE / \I g x 20.83 x 20.83 20.85 20.45 7.5' B.S.L. LOT 15 BLOCK 12 - "7.25�Mzo'. 1050(VACANT) GAL •x eh 20.16 PROPOSED 30 CONIC PAD In1 x20.66 VI N 89'47'52n W ON UNE PROPpSED RESIDENCE �9 1402-A\\ �'x 20.58 x 20.18 7.5' B.S.L. 20.58 b 20.49 S/r 133.26' LOT 16 BLOCK 12 RESIDENCE 1 FF = 22.00 > -42ROPOSED 3' 1 CONC WAD( x 19.94 2D35 PROPOSED 6' CONC DRIVE 34.25' J m J� 2D.19 20.40 FIR 1/2' 19.80 a p rM 9 X 19.52 p ,y .v. p Q O �N P�Pjj ��•i1I N CQ 9.47 m = C) „z d 2 o oa o 20.51 Op K 20.57 g7 PK NAIL 35.00' 20 SITE BENCHMARK 2 EL-20.39 12'CMP ry N. INVERT I I EL-19.81 Property Card -c((7 Page 1 of 1 JAG -SF- (9Noof Michelle Franklin, CFA -- Saint Lucie County Property Appraiser --All rights reserved. Property Identification Site Address:5305 Parcel ID: 1301-602-0041- Account#:518 Sec/Town/Range: HUMMINGBIRD WAY 000-4 11/34S/39E Map ID: 13/11S Zoning: RS-4 Use Type: 0005 Jurisdiction: Saint Lucie County Ownership Legal Description WJH LLC LAKEWOOD PARK -UNIT 2- BLK 12 LOT15 (MAP 13/1 I S) WJHFLLLC 3300Battleground-AVE Ste230 - ----- — - --------------------- Greensboro, NC 27410-2490 Current Values Historical Values 3-year Just/Market: $9,300 Assessed: $7,480 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $7,480 2018 $9,300 $7,480 $0 $7,480 2017 $6,800 $6,800 $0 $6,800 2016 $6,300 $6,300 $0 $6,300 sale History Date Book/Page Sale Code Deed Grantor Price 10-29-2018 4198/2150 0001WD Hudson III .William T $11,000 07-01-2016 3886/2476 0001 WD Cartwright Timothy $8,000 10-10-2013 3570 / 1838 0205 WD Brown William $70,000 Total Areas Finished/UnderAir 0 (SF): Gross Sketched Area 0 (SF): Land Size (acres): • 0.27 Land Size (SF): 11,880 Total Building Count: Special Features and Yard Items Type Qty Units Year Bit This information is believed'to,be correct at this time but it is subject to change and is not warranted. 0 Copyright 2019 Saint Lucie County Property Appraiser. All rights reserved. a ttps://www.paslc.org/RECard/ 4/12/2019