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Home My WebLink AboutD O H PAPERWORKPERMIT #:56-SF-1982013 \ APPLICATION #:AP1428305 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SCANNED BY S% Lucie County CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Karl Rohan PROPERTY ADDRESS: JBD Shanas Trl Port Saint Lucie, FL 34952 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1250236 File Copy LOT: BLOCK: 2 SUBDIVISION: St. Lucie Gardens [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] PROPERTY ID #: 3414-501-1008-200-3 [OR TAX 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 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 [ 667 ] SQUARE FEET Drainfield New SYSTEM R [ ] SQUARE FEET NIA SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [x] MOUND I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: Nail in fence post north of system elev. 18.6 I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D 0 T H E R I [ 24.00 1 [1 INCHES FT ][ABOVE A BELOW jBENCHMARK/REFERENCE POINT [ 12.001 INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of 9pd. SPECIFICATIONS BY. Brian Davis? TITLE: Master Septic Tank Contractor APPROVED BY: ITLE: Environmental Specialist I St. Lucie CHD Hunter A Collies DATE ISSUED: 08/28/2019 EXPIRATION DATE: 02/27/2021 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Page 1 of 3 Incorporated: 64E-6.003, FAC v 1.1.4 AP1428305 SE1199434 , NOTICE OF RIGHTS 11 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. {? K'i7'°sr�y'� oY1 Rda7 HEALTH PAYING ON: RECEIVED FROM: PAYMENTFORM: MAIL TO: Karl Rohan St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 #:56-SF-1982013 BILLOoc#:56-BID-4336023 CONSTRUCTION APPLICATION #: AP1428305 Brian Davis Septic AMOUNT PAID: $ 545.00 CREDIT CARD 022623 PAYMENT DATE: 08/12/2019 FACILITY NAME: PROPERTY LOCATION: TBD Shanas TO Port Saint Lucie, FL 34952 Lot: Property ID: 3414-501-1008-200-3 EXPLANATION or DESCRIPTION: 2 Block: 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 $ 45.00 1 $ 100.00 1 $ 100.00 1 $ 115.00 1 $ 55.00 1 $ 75.00 1 $ 50.00 RECEIVED BY: MontanezNM 1 AUDIT CONTROL NO. 56-PID-4052302 St. Lucie County Health Department Flo -HEALTH 5150 NW Milner Dr Port Saint Lucie, FL 34983 PAYING ON: u: BILLooc#56-BID-4335997 RECEIVED FROM: American Drilling AMOUNT PAID: $ 230.00 PAYMENT FORM: CREDIT CARD 0022427 PAYMENT DATE: 08/12/2019 MAIL TO: American Drilling 405 Okeechobee FL 34974 FACILITY NAME: American Drilling PROPERTY LOCATION: 405 Okeechobee FL 34974 Lot: Property ID: EXPLANATION or DESCRIPTION: -1 - Well Construction .-Irs Cil 2 n QUANTITY ' FEE $ 230.00 RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-4052279 Note: 59-29845 59-29846 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT Well tyo.t-�gg�E.�t�n 2 PERMIT NO.2-OI3 DATE PAID: FEE PAID: RECEIPT #: OaaiDa.3 A RZICaTXnN FOR; E� New Sy-= [ ] Existing System [ ] HoldingTank [ ] Repair [ ] Abandonment [ ] Innovative [ ] Temporary [ J APPLICANT: GYOZa Builders AGENT: Brian Davis Septic & Backhoe Services TELEPHONE: 772.571.8200 MAILING ADDRESS: P.0 Box 99, Fellsmere, FL 32948 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: S BLOCK: 2 SUBDIVISION: ST LUCIE GARDENS PLATTED: PROPERTY ID #: ' 3414-501-1008-200-3 ZONING: R I/M OR EQUIVALENT: [ Y PROPERTY SIZE: 1.25 ACRES- WATER SUPPLY: [ X0, I6 PUBLIC [ ]<=2000GPD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y /0 DISTANCE TO SEWER: 21 C- FT PROPERTY ADDRESS: Shanas Trl DIRECTIONS TO PROPERTY: Mer .9e on 95,Take the St Lucie Blvd,Becomes SW Prima Vista Blvd Turn R on Tilton Rd Take the 2nd R on Shanas Trl, BUILDING INFORMATION [ /L. RESIDENTIAL [ ] COMMERCIAL Unit Type of No.. of Building Commercial/Institutional System Design No Establishment Bedrooms Area Soft Table 1 Chanter 64E-6, FAC 1 House 2 / 7-012.41oor pjl ,4 tJC 3 4 [ ] Floor/Equipment Drains [ ] Other (Specify) / SIGNATURE: DATE: % ? ) ` DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.OD1, PAC Page 1 0£ d C' wo.5U-SF-Ia$2t13 STATE OFFLORIDA PERMIT APPLICATION TOCONSTRUC.T, otntcsrr� REPAIR,: MODIFY, OR'ABANDON 'A WELL DSDuthwesl PLEASE 'FILL OUT ALL APPLICABLE FICCDS Required Fields Wnere.Appli le i' ONorthwest. ('Donotes CISL Johns. River u,ev+wu, nrF»rmuororayonvolrrP CP »r,r,w�o �)„oo�yEnee^• XSouth Florida m ,an _ ,e room rt �,hr, erinrta,+ �Mr emrnr ., Suwannee. River nr w r•rrawmu ...... nke dmrumre, 0 DEP ❑ Delegated Authority (If Applicable) 2 -'_=1�J i �c� 1� - -4Vell Location - Address, Road Name or Nur 3. -Parcel ID No. (PIN) or Alternate Key .(Cir le. 4. ��.�l�-�� n edian or and Grant avmshi al No Dy4c�o'fu __ Unique ID - SupnlaWw RociWell (See At: icneu) No Delineahon No. Yes 7. 'Type of Work: 0. Construction ❑ Repair ❑' Modi6cahon❑ Abandonment 8, 'Numberof Proposed Wells f •aPPlen ror Ron»h: IAodelcsuw,.a:mw�amis�e. ate lamp f1 g -Specify Intended Use(s) of Well(s): - - AUG Z 8 Z�19 Domestic Landscape Irrigation Agricultural Irrigation ❑ Site Investigations. Bottled Water Supply B Recreation Area Irrigation LJ Livestock. ❑ Monitoring: Public Water Supply (UnniledUse/DOH) ® Nursary Irrigation ❑ Test Public Water Supply (Community or NDn-CommunilyrDEP)j�l COmmerclal/)ndustnal 9 Earth-Coupled'GeolnelmfD H in St Luele Count Class t Injection ❑ Golf Course Irrigation I. 1 HVAC Supply ENV RONMENTAL HEAL ❑ HVAC Return Class V Injection: ❑ .Recharge ❑ CommerclaVlndushial.Disposal. ❑ Aquifer Storage and Recovery ❑ Drainage Remediation: ❑. Recovery ❑ Air sparge ❑ Other (cewser - oHmalUse only. ❑ Other (ooeasef- 10,'Distance from Septic System If 5 20D ft. 11. Factl:: Djscriplfon - 12.. Estimated Start Date- 13.'Fsbmated Well Deplh,�ft• 'Esbmaled Casing .Depth�l fL Primary Casing Diameter - m. Open Hole. From_To _ft. 14. Estimated Screen Interval: From '�aTo jau W 15.'Pdmary Casing Material: Black Steel Galvanized PVC Stainless Steel Not Cased Other.. _ 16. Secondary Casing: Telescope. Casing -Liner, Surface Casing. Diameter - in. 17. Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel _ r - I8.'Method of Construction, Repair, or Abandonment:.. Auger Cable Tool Jetted Rotary Sonic Combination (Two or More Methods) Hand Driven (Well Point, Sand Point) Hydraulic oath(Directt Push) Horizontal DriNing Plugged by Approved Method Other 1e. Proposed 9rRuang al for the Primary. Secondary:: and Atldr' From i L To SeallMalenalI Benronile Neat Cemenl Other I From—_- - To seal Material,( Bunionite eo u Other _ 1 From To Seal Material ( Ber,toni e, Nest Cement Other ) From - To Seal Materiel ( Benlonile Neat Cement Other ) 20. Indicate total number of existing wells on site List number of existing unused wells on site. - 21:11sthls well or any exislin well or waterwblhd a on file owner's contiguous proper tyry covered under ConsumphveMater Use. Permit (CUPNVUP) or CUPfWUP Appllcatlon; Yes No Uyes:compieledhe idllovnng CUPlWUP No. _ District Well ID No. _ 22. Latitude - ngllude - 23NOala Obtained From: GPS Map Survey Datum: _NAD 27 _NAD 83 _WGS 84 rrdratrdr Ye,Ni awiaW�l ndYf o11,9plo. Fly, Ntrivinvalru Gedu. ehJNuonmvi � WIP41,w Na cwna ulN,M�Fu(rn As 'la"�Iv'nM m.��4�K wit�l suer M�i.ln wvp4lw,rrwlb Nud,4YYrnN.�3e,�H.M,"orp�bnal Nn.enumyn ,Ip✓: Raw '. en ,MOeme",eidW VeJur eJsPeml y,er,re.r e,,. e"d.,.e.mnFni. 1 Doi C g Wte Ir8CtDr - `Deense No. 'Signature of Owner or Agent - Ieaea Ohm Z EePi,n»on ease A Zt Hydmleeiul APProvnl Appmvat GmMPd By _ - - Lir"b Fee ReceiLad $- - Receipt No.. - Check No, THIS PERMIT IS NOTVALID UNTIL PROPERLY SIGNED BY AN AUTHORIZED OFFICER OR REPRESENTATIVE OF THE WMD OR DELEGATED AUTHORITY. THE PERMIT SHALL BE AVAILABLE AT THE WELL SITE DURING ALL CONSTRUCTION. REPAIR, MODIFICATION. OR ABAND014NIENT ACTIVITIES. _.. - - - Pow 1 of 2 STATE OF FLORIDA PERMIT Sr'\` -Lb\3 DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS r< APPLICANT: Groza .Builders AGENT: Brian Davis Septic & Backhoe LOT: 8 BLOCK: 2 SUBDIVISION: ST LUCIE GARDENS PROPERTY ID #3414-501-1008-200-3 [Section/Township/Parcel. No.. or Tax ID Number-] TO BE COMPLETED SY ENGINEER, HEALTH DEPARTEMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINNEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS �,/ i UC PROPERTY SIZE CONFORMS TO SITE PLAN: ] YES [ ] NO NET USABLE AREA AVAILABLE: .Z5 ACRES TOTAL ESTIMATED SEWAGE FLOW: 1160 GALLONS PER DAY RESIDENCES -TAB /OTHER-TABLE2] AUTHORIZED SEWAGE FLOW: GALLONS PER DAY 1500 GPD/ACRE OR 2500 GPD/ACRE] UNOBSTRUCTED- AREA. AVAILABLE: (cpt SOFT UNOBSTRUCTED AREA REQUIRED: SQFT BENCHMARK/REFERENCE POINT LOCATION: /4tI � � (C�fr,t.-c 01-2t Alt' f k, f` 5V54-� r ItL., A, 6 ELEVATION OF PROPOSED SYSTEM SITE IS_,�(rINdjlEW/FT] [ABOVEt-EiOWVBENCHMARK/REFERENCE POINT THE MINIMUM SETBAq�WHICH CAN BE MAINTAINED FROM THE PR POSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: A VI FT DITCHES/SWALES: i1'� NORMALLY WET? [ ] YES �/] NO WELLS: PUBLIC:::=FT LIMITED USE:.lf,0--�FT PRIVATE: FT NON -POTABLE: 7.6 FT BUILDING FOUNDATIONS: FT PROPERTY LINES:__L7_FT POTABLE WATER LINES: T PT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [/%] NO 10 YEAR FLOODING? ,r[ ] YES �] NO 10 YEAR FLOOD ELEVATION FOR ,SITE: �_FT MSL/NGVD SITE ELEVATION: (/(� FT MSL/NGVD SOIL PROFILE INFORMATION SITE 1 MUNSELL $/COLOR _ 0� _ ro(r 7lL _ /n •([_z /-t_ _ USDA SOIL SERIES: TEXTURE DEPTH 7 OTo 1 z- 5 /17 TO 2 I- V TO 17 -5 T TO vL L� 'yT0 L7 S"SfTO 7z- TO TO 7 USDA SOIL SERIES: (i 5 OBSERVED WATER TABLE: /� INCHES [ABOVE BEL EXISTING GRADE. TYPE: ERCHED PP ] ESTIMATED WET SEASON WATER TABLE ELEVATION: /Z INCHES [ABOVE / OKLO01 EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ] YES [` NO MOTTLING: [/]OYES [ ] NO DEPTH: 1�INCHE•S SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: G INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [ BED [ ] OTHER (SPECIFY) SITE EVALUATED BY: 1 >.I, b DH. 4015, 08109 (Obsoletes previous 'editions which may not be used) Incorporated: 64E-8.001,FAC Page 3 of ` � b 2aO' I SHED I n I�b rEBENCHMARK P 1110Na1 (No1o) faW(NAV0 8 8 l "PP - 3 _ i BLOCK2 I/ v- j 7.a L f oar t1� t 4345 \ a�aRiv w�AY \ x�x A PORT/nN nic 3L- ; kp: AO \ PROPOSED \ 6.BT 1 STORY14 BEDROOM �SINGLE FAUX YRES/DENCE o ` / BUlLUMPAD !Q =zv` 4aoe' JO•AXESSEASFNENT — ' ORB 184 PG2261 + ae_t,1� 1 ((Gf SPagT. E%nsPo� O be same sizes as in anginal K Largo plan on wall at e er i a elg sonsn -------------- MASTER SUITE cuirQau ------------- vie/[ sn u WIC u s: .5" top G LANAI v�arauw r nt.vu�u FAMILY ROOM auamn KITCHEN \ G Make this an 8068. 1'- L T131 O JISE L 5 LrxsTnr a 4 DINING 3 �e 0 O PllQ1EWplAV50M1AY1'W IS 4LfAs5M1FARIWLGVFAS msmaxRsumewmrr CONNECTORTABLE me re.mxw awia.. EM w �.ms E< nwwew e�.aweM o am awe .>NEVEE06E L rtOOwn I WxV �i] �i}% 1pEV.p6 9]9v+Al�ONMJ - +� �.uw u.r se amu;m Ern mn..++�wxrs mwec a ]an.� r w� Pm E.+m ua m ]� mssm sTP.as mwa».avmvn+a».im nx EocE rerms w]. nm uss r..].uu. ]IN�Efl W6Q(Q vECFES x-RFErufO6m.a .IaEM4v7rtCi WNERd Mq,N xTx Ew io KCET.9 Po'T SOIEDUIE i lee F777�-AI R-LAN