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HomeMy WebLinkAboutD O H PAPERWORKSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Existing New APPLICANT: Duane Bowman PROPERTY ADDRESS: 8202 Lakeland Blvd Fort LOT: 2 BLOCK: 87 FL 34951 9(I E T #:56-SF-08244 APPLICATION #: AP1447741 DATE PAID: ReCE(t o FEE PAID: FEB. 212010 RECEIPT #: Permirtin DOCUMENT #: PR1303369 81.LuCecc�t ent osxns #:05-0331-N SUBDIVISION: Lakewood Park PROPERTY ID #: 1301-608-0002-000-7 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [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 [ 900 ] GALLONS / GPD Seotic new CAPACITY A [ ] GALLONS / GPD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] K ft ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [� 375 ] SQUARE FEET R Ai' ] SQUARE FEET A TYPE SYSTEMr [ ] I CONFIGURATION: [x] N F LOCATION OF BENCHMARK: Drainfleld new SYSTEM N/A SYSTEM STANDARD [x] FILLED [ ] MOUND [ ] TRENCH [ ] BED [ ] Nail in PP SE of Z ELEVATION OF PROPOSED SYSTEM SITE [ 7.00 ][ INCHES FT ][ABOVE A BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 18.00 if INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D 0 T H E R system is sized for 3 bedrooms with a maximum occupancy of 6 perspsoo3� s per bedroom), for a total estimated flow of 9Pd j:'u: %&�" — SPECIFICATIONS BY: Brian J Ingress¢ TIC' Environmental Specialist II APPROVED BY: 42 4,..✓T'ITLE: Environmental Specialist II St. Lucie CHD Brian T In . r— DATE ISSUED: 02/14/2020 EXPIRATION DATE: 08/14/2021 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 v 1.1A A 1447741 SE1233064 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 bylaw, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. A t. M1• �rle� STATE OF FLORIDA DEPARTMENT OF HEALTH o ti'o ONSITE 'SEWAGE TREATMENT AND DISPOSAL •r i' SY.STEIK - �0py ' APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: ( ] New System [(ID Existing System ( ] Holding Tank &>-.1 Repair [ ] Abandonment [ ] Temporary APPLICANT: •6 rYBA 6.J i/NAd AGENT: MAILING ADDRESS: ff-Z O 5(e -s:F- b SA q q PERMIT NO. DATE PAID: WC, FEE PAID: RECEIPT #p: ,[ ] Innovative [ 7 TELEPHONE: / ems[ `y' ✓ �S '�� �-f� ______________________________J�===__________ -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: BLOCK: _j SUBDIVISION: 14,CP l /oaz i�4zC PLATTED: o• /� PROPERTY ID #: /3®, ^40` ,—d090-®4Z' "ZONING: I/M OR EQUIVALENT: [ YIN ] PROPERTY SIZE RZ/O a ACRES WATER SUPPLY; [/%'0 PRIVATE PUBLIC [ ]<=2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381..0065, FS7 ( YIN ] PR&tRTY ADDRESS: TO SEWER: FT DIRECTIONS TO PROPERTY: _T_Aje 'Fjjn f-g=P e a C) &W94? rOAZ. IYUV. �. BUILDING INFORMATION [/] RESIDENTIAL [ ] COMMERCIAL Unit Type of 'No. of Building Commercial/Institutional System Design No Establishment Bedrooms Area Sq£t Table 1, Chapter 64E-6, FAC. 2 / vp4,0 FI 3 4 [ ]. Floor/Equipment Drains [ ] Other (Specify) 3IGNATURE: DATE: Al 5 )H 4015, 08/09 (Obsoletes p ous*editions which may not be used) :ncorporated 64E-6.001, FAC Page 1 of 4 STATE OF FLORIDA APPLICATION # AP1447741 DEPARTMENT OF HEALTH PERMIT # 56-SF-08244 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE1233064 SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: Duane Bowman CONTRACTOR / AGENT: Duane Bowman LOT: 2 BLOCK: 87 SUBDIVISION: Lakewood Park ID#: 1301-608-0002-000-7 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: 300 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: 565.00 SQFT UNOBSTRUCTED AREA REQUIRED: 563.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: Nall In PP SE Of System ELEVATION OF PROPOSED SYSTEM SITE 7.00 [ INCHES / FT ] [ ABOVE / BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: 50 FT DITCHES/SWALES: 70 FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 75 FT NON -POTABLE: FT BUILDING FOUNDATIONS: FT PROPERTY LINES: FT POTABLE WATER LINES: FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES EX ]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 USDlA SOIL SERIES: Munsell#/Color Texture Depth 1 OYR 4/1 Fill - Loamy Sand 0 TO 9 1 OYR 513 Fill - Sand 9 To 31 10YR 5/1 - Sand 31 To 41 1 OYR 6/1 ,10YR Sand 35 To 64 312 Sand 64 To 72 USDA SOIL SERIES: Munsell #/Color Texture Depth 1 OYR 411 Fill - Sand 0 To 11 1 OYR 5/3 Fill - Sand 11 To 31 1OYR 5/1 Sand 31 To 45 10YR 611 Sand 37 To 58 1 OYR 412 Sand 58 To 64 1 OYR 312 Sand 64 To 72 OBSERVED WATER TABLE: 69.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 35 INCHES [ ABOVE / FBSLOWI] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 35.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY) 7 .REMARKS/ADDITIONAL CRITERIA WSWT determined using USDA WSS and soil borings. 10YR6/1 stripping in 10YR5/1 matrix >10% with diffuse boundaries starting at 35" In SB1. SB1 7" below SM. S132 5" below SM. ' SITE EVALUATED BY: / DATE: 11/21/2019 Ingram, Bri (Title: Environmental Specialist II) (ENVIRONMENTAL HEALTH) DH 4015, 00/09 (Obsoletes previous adition which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 AP1447741 EID350171 v 1.0.2 Misslon: To protect, promote & Improve the health of a8'people inFlodda Ihmugh Integrated state, county& communty efforts. G HEALTH Vision: To be the Healthleat State in the Nallon February 6,.2020 Ron DeSantis Governor Scott A. Rivkeos, MD State Surgeon General Mr. Duane Bowman 8202 Lakeland Boulevard Fort Pierce, Florida 34951 RE-. VarianceRequest 'for an Onsite Sewage Treatment and Disposal System Variance Application #13810 Florida Department of Health in St. Lucie County Reference#56-SF-08244 Lot 2, Block 97; Lakewood Park Unit No. 8 8202 Lakeland. Boulevard, St. Lucie County: Variance from Section: 381.0065(4)(g)2., Florida Statutes; 64E-6.005(4)(a), Florida Adrninistrative Code Dear Mr. Bowman: The Variance Review and Advisory Committee for the Onsite Sewage Treatment and Disposal Program has recommended disapproval..of your application for variance in the case of the above referenced property. After reviewing your request.and considering the committee's recommendation, i have tabled your request for variance. Please send the following additional` information to the Department of Health in St. Lucie County for A. them;to review and make comments and to forward to the Bureau of Onsite Sewage -Programs for consideration in making a final decision: 1. A site plan prepared in accordance with sat 64E-6.004(3)(a), Florida. Administrative Code, drawn to:scale and showing the locations of the proposed onsite:sewage treatment and,disposal system septic tank.and drainfteld, the shoulders and the toe of the slope. The site plan shall 'show all pertinent features including the mean annual flood line of the permanent nontidal surface water body. 2. Altemative onsite sewage treatment and disposal system designs to maximize the setback to the surface water. You may also want to consider shifting the house locatiori to. provide sufficient room for the onsite system. The, Florida Department of Health will consider this and any other information you provide. However, you should not. assume: that the submission of the requested' materials will result Ina favorable 'decision.-ShouldIthe information not be received within six (6) monthsof the date of this letter, your variance request will be denied. Florida'Department of Health Division of Disease Cohhol & Health ProteEfon • Bureau of Envitonmental Heallh 4052 Bald Cypress way, Bln A-08 Tallahassee, n. M99-nlo Accredited Health Department PHONE: 85=45-4250• FAx e040-0e64 = Public Wealth Accreditation Board FloridaHealth.gov Mr. Bowman (Variance.#13810) Page Two February 6; 2020 If you have any questions, please call.Ed Williams at 850-901-6522. Sincerely, Kendra.F. Goff, PhD, DABT, CPM, CEHP State Toxicologist & Chief tp KFG/ew cc: Florida Department of Health in St. Lucie County J STATE OF FLORIDA a APPLICATION FOR VARIANCE FROM CHAPTER 64E-6, FAC Vo,leneaAppllcunonNumbOr 3 e STANDARDS FOR ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEMS 'y,Ww•�,' Authority: Chapter 381, Florida Statutes omRasmgeotfimumOnly Chapter 64E-6, Florida Administrative Code Follow the instructions on the back of this forth for assembring your application for variance. Eight (8) copies of this form and supporting documentation must be submitted with the required fee to your local county health department Your application must be reviewed by the local county health department and the completed application received by the Bureau'of Onsile Sewage Programs in Tallahassee no later than the 15th of the month to be placed on the agenda for the next monthly meeting of the variance review and advisory committee. If the 15th falls on a weekend or legal holiday, the deadline for receipt will be the next regular working day. If the variance request Involves setbacks from wells or surface waters, the separation of the drainfield from the estimated wet season high water table, or the authorized sewage flow of the property, the county health department must post a sign on the property giving notice of the application for variance. PART I - GENERAL INFORMATION (To be completed by the applicant. See Instructions on the back of this form.) APPLICANTINFORMATION(TYPE OR PRINT LEGIBLY) �) ,s PropeAyOwner. I UAADE- E LfN� e3OWA\A)1.) Owner's PROPERTY INFORMATION Segfion: Township: Range: Parcel Number.��%�'ro�c IM Metes & Bounds Description (Attach property legal description) VARIANCE REQUEST INFORMATION A variance may not be granted under section 381.0065, FS, until the department is satisfied the following conditions have been met. .Address each Rem explaining how your variance request satisfies the statutory conditions for a variance. Attach a separate sheet If necessary. 1. Please applicant. 2. Please explain how your variance request safls es the cost, exists for the treatment of thesewaru 4- , no the hardehlp was taking into by the action of the factors such as 3. Please explain how your variance request satisfies the statutory requirement that the discharge from the onsite sewage treatment and disposal sy!4m will not 5dvereely affect the health of tpg applirypnt or the ppblic or signifjrxntly dggrede the groundwater or surface waleM. .I attest the abo4e Information Isbire. a tills tin the sub {orfaf this variance request, I onto my property to conduct inspect' n e I and top p notice of this variance request. Signature of Owner or Agent authorize department employees to Datv',(—/ �v J DH 4057, 08109 (Obsoletes all previous eji ons which may not be used) Incorporated: 64E-6.004, FAC Page 1 of 2 PART II - COUNTY HEALTH DEPARTMENT INFORMATION (To be completed by the county health department. See instructions on the back of this form.) (TYPE OR PRINT LEGIBLY) County Health Department Use Only County Reference Number 56-SF-08244 Fee Paid 2g 45.00 Date 12/11111 Receipt Number REASON STANDARDS CANNOT BE MET SPECIFIC SECTION(S) OF 381.0066, F.S. REASON REQUIREMENTS IN THE SECTION CANNOT BE MET OR 64E-6, F.A.C., INVOLVED IN REQUEST (include the quantity of the deviation from the requirement) 381.0065(4)(g)2, F.S. A portion of the unobstructed area does not meet the required 50' surface water setback for lots platted prior to 1972. 64E-6.005(4), F.A.C. If the required 50' surface water body setback is maintained there is insufficient unobstructed area. SITE INFORMATION (Attach a completed site evaluation form) Connection distance from property to sanitary sewer is N/A feettmiles. Lots in the vicinity of the subject property are generally: ❑ Larger ❑ Smaller E Same Size Buildings on this property are: ® Proposed ❑ Existing ❑ Under Construction The OSTDS involved in this variance request is: ❑ Proposed ❑ Installed ® Existing (Previously approved) Proposed property use is: IKI Unchanged ❑ Increased ❑ New Use Are there known OSTDS failures in the area? ® No ❑ Yes ... Reason(s): ❑ Lot is posted with a sign in accordance with the instructions on the back of this form. Comments from the county health department (attach additional sheets if necessary): The owner of the property would like to use the existing septic tank, as it currently meets all required setbacks, but has revised its location in an attempt to make more effective use of space. ­3� ZAV:— Title: Environmental Supervisor Date: 12 f 13 1 19 Signature of Environmental Health Director or designee NOTICE 1. Procedures leading to the submission of this variance request must be in accordance with Chapter 120, Florida Statutes. 2. This completed application must be received by the Department of Health, Onsite Sewage Office in Tallahassee no later than the 15th of the month to be placed on the agenda for the next monthly meeting of the variance review and advisory committee. If the 15th falls on a weekend or legal holiday, the deadline for receipt will be the next regular working day. 3. If the variance request involves setbacks from wells or surface waters, the separation of the drainfield from the estimated wet season high water table, or the authorized sewage flow of the property, the county health department shall post a sign on the property. DH 4057, 08109 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.004, FAC Page 2 of 2 YG HEALTH PAYING ON: RECEIVED FROM: PAYMENTFORM: St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 #:56-SF-08244 BILL DOC#:56-BID-4503976 CONSTRUCTION APPLICATION #: AP1447741 Duane Bowman AMOUNT PAID: $ 245.00 CREDIT CARD 09516TPAYMENT DATE: 12/11/2019 MAIL TO: Duane Bowman FACILITY NAME: Tonv Sommo PROPERTY LOCATION: 8202 Lakeland Blvd Fort Pierce, FL 34951 Lot: 2 Block: 87 Property ID: 1301-608-0002-000-7 EXPLANATION or DESCRIPTION: QUANTITY FEE .136 - OSTDS Construction Variance Single Family 1 $ 200.00 -1 - Surcharge (All) 1 $ 45.00 a RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-4247270 Mission: Ron DeSantis Governor To protect, promote & improve the health of all people in Florida through Integrated stale, county & community efforts. Vision: To be the Healthiest State in the Nation December 11. 2019 Duane Bowman 8202 Lakeland Boulevard Fort Pierce, FL 34951 Application Denial and Notice of Right to Administrative Proceedings Application Document No: AP1447741 8202 Lakeland Blvd Fort Pierce, FL 34951 Lot: 2 Block: 87 Subdivision: Lakewood Park Dear Applicant: Scott A. Rivkees, MD State Surgeon General This will acknowledge receipt of an application and plans for an onsite sewage treatment and disposal system construction permit dated October 10, 2019 for a proposed system to be constructed on the above referenced property. You are hereby notified that your application is denied because the proposal described does not meet the requirements of section 381.0065, Florida Statutes, or Chapter 64E-6, Florida Administrative Code. Specifically the proposal has the following violations: Code Citation 381.0065(4)(g)2, F.S. 64E-6.005(4), F.A.C. Letter Detail A portion of the unobstructed area does not meet the required 50' surface water setback. If the required 50' surface water setback is maintained, there is insufficient unobstructed area. Code Citation Description Setback from surface water bodies Pre-72 lot Unobstructed land not available As an applicant who has been denied a permit, you have the right to request a variance or hearing to appeal the department's action. Requests for a hearing must be made to this office in writing no later than 21 days from the receipt of this letter. Mediation pursuant to S.120.573, Florida Statutes, is not available to resolve this dispute. Florida Department of Health www.FloridasHealth.com In ST. LUCIE COUNTY 1 TWITTER:HealthyFLA 5150 NW Milner Dr, Port Saint Lucie, FL 34983 FACEBOOK:FLDepartmentofHealth PHONE: (772) 873-4931 . FAX: (772) 873-4893 YOUTUBE: fidoh Duane Bowman Page two December 11, 2019 Your lot may qualify for a performance based treatment system under Part IV, Chapter 64E-6, Florida Administrative Code. You should consult with a professional engineer registered in Florida for further information on performance based systems. If you have any questions on this matter, please call our office at (772) 873-4905. Sincerely, Brian Ingram, Environmental Specialist II Duane Bowman Page three December 11, 2019 NOTICE TO POTENTIAL VARIANCE APPLICANTS If pursuing a variance application, please note that the following information is taken from the section of Florida Statutes dealing with variance applications for onsite sewage treatment and disposal systems. To find the Florida Statutes on the internet, please go to http://www.leg.state.fl.us/Statutes/index.cfm. Scroll down and click on 'Title XXIX." Find and click on "Chapter 381." Find and click on "381.0065." The citation to look for is Chapter 381.0065(4)(h)1., Florida Statutes. The department may grant variances in hardship cases which may be less restrictive than the provisions specified in this section. A variance may not be granted under this section until the department is satisfied that: a. The hardship was not caused intentionally by the action of the applicant; b. No reasonable alternative, taking into consideration factors such as cost, exists for the treatment of the sewage; and c. The discharge from the onsite sewage treatment and disposal system will not adversely affect the health of the applicant or the public or significantly degrade the groundwater or surface waters. Where soil conditions, water table elevation, and setback provisions are determined by the department to be satisfactory, special consideration must be given to those lots platted before 1972. While the final authority to grant or deny variances rests solely with the Department of Health, variance applications are reviewed by a State Variance Review and Advisory Committee. The committee meets once a month in a predetermined location in Florida. You are invited to attend, at your own expense, or send someone to represent you. The committee will evaluate your request during the meeting, and will make a recommendation on the disposition of your application to the department. Please note there are specific requirements and deadlines for variance applications. Please call your local county health department representative for information on how to file for a variance request. MObfl(f"M -JUEEDS SOILS St. Lucie County Health Department A051 a 5150 NW Milner Dr Port Saint Lucie, FL 34983 HEALTH PAYING ON: #:56-SF-08244 BILL DOC#:56-BID-4457075 CONSTRUCTION APPLICATION#: AP1447741 RECEIVED FROM: Duane Bowman AMOUNT PAID: $ 345.00 PAYMENT FORM: CREDIT CARD PAYMENT DATE: 10110/2019 MAIL TO: Duane Bowman FACILITY NAME : Tony Sommo PROPERTY LOCATION: 8202 Lakeland Blvd Fort Pierce, FL 34951 2 Lot: Property ID: 1301-608-0002-000-7 EXPLANATION or DESCRIPTION: 87 Block: 130 - OSTDS Construction System Inspection Training Cent -1 - Surcharge (All) 124 - OSTDS Construction Repair or Mod Site Evaluation 127 - OSTDS Construction System Inspection 129 - OSTDS Construction Permit (Repair) 131 - OSTDS Construction Application & Existing System E QUANTITY FEE 1 $ 5.00 1 $ 45.00 1 $ 115.00 1 $ 75.00 1 $ 55.00 1 $ 50.00 RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-4196299 St. Lucie County Health Department 67tW . 5150 NW Milner Dr Port Saint Lucie, FL 34983 HF.Qd.TH PAYING ON: a:56-SF-08244 BILL Doca:56-BID-4462093 CONSTRUCTION APPLICATION#: AP1447741 RECEIVED FROM: Duane Bowman AMOUNT PAID: $ 35.00 PAYMENT FORM: CREDIT CARD 01467T PAYMENT DATE: 10/17/2019 MAIL TO: Duane Bowman FACILITY NAME: Tony Sommo PROPERTY LOCATION: 8202 Lakeland Blvd Fort Pierce, FL 34951 Lot: 2 Block: 87 Property ID: 1301-608-0002-000-7 EXPLANATION or DESCRIPTION: QUANTITY FEE 139 - OSTDS Application Approval Existing, No Insp 1 $ 35.00 RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-4202027 5(e -s:F- 6 a y ° STATE OF FLORIDA PERMIT NO. 'DEPARTMENT OF HEALTH DATE PAID: Q Wo ONSITE 'SEWAGE TREATMENT AND DISPOSAL FEE PAID: SYSTEI4 .. RECEIPT #: APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [ J New System pqzr Existing System [ ] Holding Tank ,[ ] Innovative [fie] Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT: ` SULf A#Ue 00W MA4--J d6D/a-,)1,o /U cS SO V,,v 61!!•(La21 AGENT: .LDt hej 4L. /�'!7 TELEPHONE: ��e0l •QQv �� MAILING ADDRESS: Z Q Z I—Ake-144�/l ____________ _3__!_�_____________ 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 � (./N�� LOT: ` BLOCK: —� SUBDIVISION: r%C��CJO�(/ d�e �% PLATTED: /• /9 PROPERTY ID #:��//JJ%�a�,-�L(�J��dpQ"•ZONING: I/M OR EQUIVALENT: [ Y/N ] PROPERTY SIZE Z4 ACRES WATER SUPPLY: [x] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381..00/�665,//FS? [/Y/N ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: _R267 �/1 llL]Aa/•U Alvp _ �/�/I/�@_ �/, DIRECTIONS TO PROPERTY:-,-m4e/Q 7e( � � ` �elzxo -a 14v e, . , BUILDING INFORMATION 1 /] RESIDENTIAL [ ] COMMERCIAL Unit Type of 'No. of Building Commercial/Institutional System Design No Establishment Bedrooms Area Table 1, Chapter 64E-6, FAC. �-Sggft�' 2 3 4 [ •] Floor/Equipment D5Ains,`[ ] Other (Specify) SIGNATURE: DATE: /to 7 DH 4015, 08/09 (Obsoletes p ous•editions which may not be used) Incorporated 64E-6.001, FAC Page 1 of 4 I STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: Duane Bowman CONTRACTOR / AGENT: Duane Bowman LOT: 2 BLOCK: 87 SUBDIVISION: Lakewood Park ID#: 1301-608=0002-000-7 APPLICATION # AP1447741 PERMIT # 56-SF-08244 DOCUMENT # SE1233064 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: 300 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: 500.00 SQFT UNOBSTRUCTED AREA REQUIRED: 563.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: Nail In PP SE of system ELEVATION OF PROPOSED SYSTEM SITE 7.00 [FINCHES] / FT ) [ ABOVE / BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: 50 FT DITCHES/SWALES: 70 FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 75 FT NON -POTABLE: FT BUILDING FOUNDATIONS: FT PROPERTY LINES: FT POTABLE WATER LINES: FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES IX]NO 10 YEAR FLOODING? [ ]YES [X]NO] .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: Munsell#/Color Texture Depth 10YR 4/1 Fill - Loamy Sand 0 To 9 I OYR 513 Fill - Sand 9To 31 10YR 5/1 Sand 31 To 41 10YR 6/1 Sand 35 To 64 10YR 3/2 Sand 64 To 72 USDA SOIL SERIES: Munsell #/Color Texture Depth 10YR 4/1 Fill - Sand 0 To 11 1 OYR 5/3 Fill - Sand 11 To 31 10YR 5/1 Sand 31 To 45 1OYR 6/1 Sand 37 To 58 10YR 4/2 Sand 58 To 64 1 OYR 3/2 Sand 64 To 72 OBSERVED WATER TABLE: 69.00 INCHES [ ABOVE / EELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 35 INCHES [ ABOVE / BELOW]] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 35.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA WSWYRT determined using USDA WSS and soil borings. 10611 stripping In 10YR5/1 matrix>10% with diffuse boundaries starting at 35" In SBIL SB1 7" below BM. SB2 5" below SM. .1-1 SITE EVALUATED BY: Ingram, Brian (Tide: Ej)4)ronmental Specialist III (ENVIRONMENTAL HEALTH) DH 4015, 08/09 (Obsolete. previous edition. which foot be used) I ... x rated: 64E-6.001, FAC DATE: 11/21/2019 Page 3 of 4 AP1447741 EID350171 v 1.0.2 Property Card Page 1 of 1 Michelle Franklin, CFA — Saint Lucie County Property Appraiser -- All rights reserved. Property Identification Site Address:8202 Parcel ID:1301-608-0002- Account #: 2001 Sec/Town/Range: LAKELAND BLVD 000-7 02/34S/39E Map ID: 13/02N Zoning: RS-4 Count Use Type: 0000 Jurisdiction: Saint Lucie County Ownership Legal Description Duane C Bowman LAKEWOOD PARK -UNIT 8- BLK 87 LOT2 (MAP 13/02N) Linda S Bowman 4650 Washington ST Apt 1 I Hollywood, FL 33021 Current Values Historical Values 3-year Just/Market: $15,200 Assessed: $12,399 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $12,399 2019 $15,200 $12,399 $0 $12,399 2018 $18,300 $11,272 $0 $11,272 2017 $17,100 $10,248 $0 $10,248 Sale History Date Book/Page Sale Code Deed Grantor Price 06-19-2019 4286 / 0688 0001 WD Sommo Anthony R $27,000 01-18-2005 2147 / 1720 XX00 TR Roane (TR) Harriet S $80,000 10-07-2003 1820 / 0174 XX00 WD Lawhon Christopher $44,000 Primary Building Information Finished Area of this building: 0 SF Gross Sketched Area: 0 SF View: Year Built: N/A Primary Wall: Bedrooms: 0 Full Baths: 0 Half Baths: 0 Roof Cover: Frame: Story Height: A/C %: 0% Heated %: N/A% Sprinkled %: 0% Exterior Data Roof Structure: Grade: No. Units: 0 Interior Data Electric: Heat Type: Heat Fuel: Building Type: Effective Year: N/A Secondary Wall: Primary Int Wall: Avg Hgt/Floor. 0 Primary Floors: Total Areas Finished/UnderAir 0 (SF): Gross Sketched Area 0 (SF): Land Size (acres): 0.27 Land Size (SF): 11,700 Total Building Count: 1 Special Features and Yard Items Type Qty Units Year Bit All information is believed to be correct at this time, but is subject to change and is provided without any warranty. © Copyright 2019 Saint Lucie County Property Appraiser. All rights reserved. https://paslc-dev.org/RECard/ 10/10/2019 SAT MU VI.: 1. L L Custom Soil Resource Report St. Lucie County, Florida 4—Arents, 0 to 5 percent slopes Map Unit Setting National map unit symbol: ljptx Elevation: 10 to 20 feet Mean annual precipitation: 49 to 58 inches Mean annual air temperature: 70 to 77 degrees F Frost -free period., 350 to 365 days Farmland classification: Not prime farmland Map Unit Composition Arents and similarsods: 90 percent Minor components: 10 percent Estimates are based on observations, descriptions, and transacts of the mapunit. Description of Arents Setting Landform: Rises on marine terraces Landform position (three-dimensional): Rise Down -slope shape: Convex Across -slope shape: Linear Parent material., Altered marine deposits Typical profile C1 - 0 to 10 inches: sand C2 - 10 to 51 inches: sand A/Eb - 51 to 80 inches: sand Properties and qualities Slope: 0 to 5 percent Depth to restrictive feature: More than 80 inches Natural drainage class: Somewhat poorly drained Runoff class., High Capacity of the most limiting layer to transmit water (Ksat): High to very high (5.95 to 19.98 in/hr) Depth to water table: About 18 to 36 inches Frequency of flooding: None Frequency of ponding: None 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 3.0 inches) Interpretive groups Land capability classification (irrigated): None specified Land capability classification (nonirrigated): 6s Hydrologic Soil Group: A Forage suitability group: Forage suitability group not assigned (G156BC999FL) Hydric soil rating: No 10 Custom Soil Resource Report Minor Components Sanitary landfill Percent of map unit. 5 percent Hydric soil rating: Unranked Canaveral Percent of map unit: 5 percent Landform: Ridges on marine terraces, dunes on marine terraces Landform position (three-dimensional): Interfluve Down -slope shape: Convex Across -slope shape: Linear Hydric soil rating: No 99—Water Map Unit Composition Water. 100 percent Estimates are based on observations, descriptions, and transacts of the mapunit. 11 5 STATE OF FLORIDA • -.,. �' DEPARTMENT OF HEALTH �i ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM ° 10 EXISTING SYSTEM AND SYSTEM REPAIR EVALUATION APPLICANT: DUANE BOWMAN AGENT : ALL COUNTY SEPTIC AND PLUMBING PERMIT # LOT: 2 BLOCK: 87 suBDiv: LAKEWOOD PARK ID#: 1301-608-0002-0( TO BE COMPLETED BY FLORIDA REGISTERED ENGINEER, DEPARTMENT EMPLOYEE, SEPTIC TANK CONTRACTOR OR OTHER CERTIFIED PERSON. SIGN AND SEAL ALL SUBMITTED DOCUMENTS. COMPLETE ALL APPLICABLE ITEMS. COMPLETE TANK CERTIFICATION BELOW OR NOTE IN REMARKS WHY THE TANKS CANNOT BE CERTIFIED. EXISTING TANK INFORMATION C 1050 ] GALLONS SEPTIC TANK LEGEND: FSI 01-011C3 MATERIAL: CON BAFFLED: [Y I [ ] GALLONS SEPTIC TANK LEGEND: MATERIAL: BAFFLED:[Y/N ] [ ] GALLONS GREASE INTERCEPTOR LEGEND: MATERIAL: [ ] GALLONS DOSING TANK LEGEND: MATERIAL: # PUMPS:[ ] I CERTIFY THAT THE LISTED TANKS WERE PUMPED ON %© /Z1-/ 19 BY ALL COUNTY SEPTIC HAVE THE VOLUMES SPECIFIED AS DETERMINED BY [ DIMENSIONS ], ARE FREE OF OBSERVABLE TS o S, AND HAVE A [ SOLIDS DFFLECTION DEVICE ] INSTALLED. �DE /� �j�- ALL COUNTY SEPTIC AND PLUMBING 10/22/19 IGNAT fL�E OF LICENSED CONTRACTOR BUSINESS NAME DATE EXISTING DRAINFIELD INFORMATION 1625 ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM NO. OF TRENCHES C ] DIMENSIONS: 42 X11 [ ] SQUARE FEET SYSTEM NO. OF TRENCHES [ ] DIMENSIONS: X TYPE OF SYSTEM: [ ] STANDARD [✓] FILLED [ ] MOUND [ ] CONFIGURATION: [ '] TRENCH C ✓ ] BED [ ✓ ] 25 EQ36 DESIGN: [J] HEADER [ ] D-BOX [ ✓] GRAVITY SYSTEM C ] DOSED SYSTEM ELEVATION OF BOTTOM OF DRAINFIELD IN RELATION TO EXISTING GRADE 27 INCHES [BELOW '] SYSTEM FAILURE AND REPAIR INFORMATION [2006 ] SYSTEM INSTALLATION DATE TYPE OF WASTE [✓] DOMESTIC [ ] COMMERCIAL [400 ] GPD ESTIMATED SEWAGE FLOW BASED ON [ ] METERED WATER [J] TABLE 1, 64E-6, FAC SITE [ 7 DRAINAGE STRUCTURES ( ] POOL [ ] PATIO / DECK [ ] PARKING CONDITIONS: [ ] SLOPING PROPERTY [✓] CLEAR NATURE OF [ ] HYDRAULIC OVERLOAD [ ] SOILS FAILURE: [ ] DRAINAGE / RUN OFF [ ] ROOTS FAILURE [ ] SEWAGE ON GROUND SYMPTOM: ( ] PLUMBING BACKUP REMARKS/ADDITIONAL [ ] MAINTENANCE ( ] SYSTEM DAMAGE [ ] WATER TABLE [ J ] CERT [ ] TANK [ ] D BOX/HEADER [ ] DRAINFIELD [J] CERT SUBMITTED BY/�� --TITLE/LICENSEPRES 61509 DATE: 10/23/19 DH 4015, 08/ 9 ( soletes previous editions which may not be used) Incorporated 64E-6.001, FAC Page 4 of 4 eBridge'We'b Viewer Pre,r_'o=1ppr� oval a4 o STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM • +� CONSTRUCTION INSPECTION AND FINAL APPROVAL �69on ,9eR�`. Authority: Chapter 381, FS & Chapter 20D-6, FAC APPLICANT: �nln1 % '^Y1 kk APV}n AGENT: /n k. PESMIT B RECEIPT FEE PAID $ DID PROPERTY STREET ADDIRIs55 t /!7{ / )l s, OlhAA4 � (/-,I I HX t Page 4 of 18 LOT: SUBDIVISION1 CIO VG_i SH(lld 'Ivk/Q►J PROPERTY ID [SECTIOA/TTOWNNSHIIP/RANGS/PARCEL NUMBER] [OR TAX ID NUMBER], CHECKED [X) ITEMS ARE NOT IN COMPLIANCE WITH CHAPTERADD-6, FLORIDA ADMINISTRATIVE CODE. ---=cne=n= TANK INSTALLATION SETBACKS [ 1 (O11 TANK SIZE (1] /0 121 & ( 1 I271 SURFACE WATER [ 1 (02] TANK MATERIAL 1 1 [281 DITCHES [ 1 (031 OUTLET DEVICE [ 1 1.29] PRIVATE WELLS [ 1 [041 MULTI-CRAMBERO I ] 1301,PUBLIC WELLS [ 1 [051 LEGEND _ F`JtOJ-'a Gl..o4 ��.6� ( 1 (31] IRRIGATION WELLS 1 1 [061 WATERTIGHT I 1 1321 POTABLE WATER LINES I I [071 LEVEL ( 1 1331 BUILDINGf FOUNDATION [ 1 (081 DEPTH OF LID [ 1 (341 PROPERTY LINES ( ] [351 OTHER DRAINFIELD INSTALLATION, [ 1 [101 AREA [1] �Q3% [2 L72�" SQFS [ ] [10] DISTRIBUTION BO_x�n�_ [ ] 1111 NUMBER OF DRAINLINE _ ^ I 1 1121 DRAINLINE SEPARATION [ ] 113] DRAINLINE SLOPE I ]; ] ] [141 115] DEPTH OF COVER SYSTEM ELEVATION k#z i3u�i l [ ] [161 SYSTEM LOCATION [ ]-1[171 DOSING PUMPS_ [ ] 1281 AGGREGATE SIZE [ ) (19) AGGREGATE SOURCE [ ] 1201 AGGREGATE WASHED I 1 1211 AGGREGATE DEPTH FILL/EXCAVATION MATERIAL ' [ ] [221 'VILL AMOUNT ' [ ] 1231 FILL TEXTURE ( 1 1241 EXCAVATION,DEPTW- y [ 1 125] EXCAVATION AREA [ ] 1261 REPLACEMENT MATERIAL• : EXPLANATION OF VIOLATIONS. •.� [ ] m WIWI CONSTRUCT [APPROVE /DISAPPROVED] 1-4 FINAL SY9 PRO /DISAPPROVED]t ( 0H 4016. 9/96 )ROPIaGee NRSdt Form 4016 ]Pepe 21 Which may be used) ):rout Number: 314400&4016.4) ` FILLED/MOUND SYSTEM ( 1 (361 DRAINFIELD COVER [ 1 [371 SHOULDERS [ 1 [ 1 [381 [391 SLOPES STABILIZATION MATERIAL ADDITIONAL INFORMATION [ J [401 UNOBSTRUCTED AREA [ ] [411 STORKWATER RUNOFF [ ] 1421 ALARMS [ 1' 1431 MAINTENANCE AGREEMENT I 1 [441 BUILDING AREA I 1 [45] PLUMBING FIXTURES 1 ] 146] FINAL SITE ORADIH((jJ�r/ � [ J 147] +1 CONTRACTOR j'J4+ Y�I [ ] (48] OTHER ztr I ABANDONMENT I 1 [491 TANK PUMPED I ] (501 TANK CRUSHED AND FILLED DATE: JGV DATE: 7 8 Page 2 of 2 APAUCAUr J https://s1.ebridge.com/ebridge/3.0/webviewerNiewer.aspx?ref--5xaXP3mfsfJxjUnxmZESo VMV80CDs... 10/15/2019 Pa eg 5 of 18 5M 117 DATEPA #: 56-88-08244 D n DATE PAID; FEE PAID ; $ RECEIPT OSTDSNBR 05-0--- 331- [ 1 Innovative Other APPLICANT: sommo, Ton ] . AGBNTr LEZU ER PROPERTY STREEPIAZZA T ADDRESS: - - - e20a Lakela"A eBrid'ge' Web Viewer ems r rev rous STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERi42T CONSTRUCTION PERMIT FOR: [ 8 ]New System [ Repair ]Existing System ]Abandonment [ ]Holding Tank C ][ C L ITeropora LOT: 2 rz BLOCK: 87 SUBDIVISION: PROPERTY Lakewood ID !SeLtionr [OR TAR ID SYSTEM MUST BE CONS ERUCTED L� DEPARTMENT APPROVAL OF SYS IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF PERIOD. 11NY � � IN MATERIAL FACTS NOT GUARANTEE SATISFACTORY pERFO CHAPTER 64E-6,FAC REQUIRE THE APPLICANT TO FACT3 WHICH SERVED PERFORMANCE FOR ANY SPECIFIC TIME PERMIT BEING MADE MODIFY AS A BASIS FOR ISSUANCE of TH25 PERMIT, THS PERMIT APTHISPLICATION. SUCH MObIFICATIONS MAY RESULT IN THIS COMPLIANCE WITH BE AND VOID. ISSUANCE OF R FEDERAL, STATE OR LOCAL P—MITTri PERMIT DOES NOT EXEMPT THE APPLICANT FROM SYSTEM DESIGN AND SPECIE] REQUIRED FOR PROPERTY DEVELOPMENT. CATIONS DTI- �ERED/IN SERIES: ERED/IN SERIES: ] GALLONS O LO )DOSES PER 24 BRS RD -[ 61_ 00 ]SQUARE FEET FEET PRIMARY DRAINPIELD SYSTEM A TYPE SYSTEM: SYSTEM I CONFIGURATION: N STANDARD I Y ]FILLED N _ ] TRENCH [ Y ] BED 1° LOCATION TO I ELEVATION OF OPCSTBENCHMARK.0 L of Road Center o E BOTTOM OF D PROPOSED.SYSTEM SITE [ f Lot L RAINFIELD TO Bfi [ 6.0 ] [ INC889 ] D FILL REQUIRED ] [ INCBBs : ) [ 7.0 ']INCHES T [ 1050 ]Gallons SEPTIC TANK N00 ]Gallons K [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY (GALLONS DOSING TANK CAPACITY [ -0 I N ]MOUND [ N ] dNl_ [Y ] IY ] # PUMPS[ 0 ] I ABOVE IBENCHMARg�REFERHUCE POINT [ ABOVE]BENCHMARK/REFERENCfi POINT EXCAVATION REQUIRED. [ 64.0 ] INCHES ;ategory of in accordance rdance iag the system is responsible for iaetalliac salt in accordance with B. 64B-6.013 (3) (f) , PAC. ProaconstraatioaVert to maet ghe me inches Wove reference Must aubrcc as meeting a 4uired with septic t Point. Excavation can 000-atioa to be s acontractor and surveyor. Plea prior to inspection.spec submitted prior to inspection. ECIFICATIONS BY: DVNCAN, JAMES PROVED BY: TITLE: Poliael .7cdi . TITLE, Environmental spa. St. L-1_ CE ISSUED; 6/13/05CHD :016, 03/97 (Obsoletas previous editloba used) xk Number, S744-001-4016-0) vbiob MY sot be r�OW!-OOHS �016-1r EXPIRATION DATE: 12/13� /06 .Ittps://sl .0/webviewer/Viewer WHV80CDs... 10/15/2019 eBridge' Web Viewer ., reviovS v Page 7 of 18 STATE OF FLORIDA DEPARTMENT OF HEALTH e ONSITE SEWAGE TREJMdE NT AIM DISPOSAL ,�� SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [ X ] New System [ ] Existing System [ ] Bolding Tank [ ] Repair [ ] Abandonment [ l Temporary APPLICANT: TONY SOMMO _ PERMIT no. DATE PAID: /a FEE PAID: RECEIPT U: [ ] Innovative [ ] AGENT: Alexander J. Piazza PSM, Inc. TELEPHONE: 1-772-380-0000 MAILING ADDRESS: 2216 SE Industrial Boulevard, Port St. Lucie, Florida 34952 TO BE COMPLETED BY.APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MOST, 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 (WM/DD/YY) IF REQUESTING CONSIDERATION.pF STATUTORY GRANDFATHER PROVISIONS. PROPERTY INFORMATION LOT: 2 BLOCK: 87 PROPERTY ID #: DATE LMMWOOD PARR UNIT NO. 8 PLATTED: `69 [Section/Township/Range/Parcel No.] ZONING: PROPERTY SIZE: 0.27 ACRES [Sgft/43560] PROPERTY WATER SUPPLY: [R] PRIVATE [ ] PUBLIC PROPERTY STREET ADDRESS: 8202 LAICELAND BOULEVARD FORT PIERCE FLORIDA 34951 DIRECTIONS TO PROPERTY: SEE MAP BUILDING INFORMATION [ X ] RESIDENTIAL [ ] COMMERCIAL Unit Type of No. of Building Commercial/Institutional System Design No Establishment Bedrooms Area Sq£t Table 1, Chapter 64E-6, FAC 1 Residential 4 2127 2 3 4 [ x Garbage Grindere/Diepcsals [ )C]•'Spas ./.Hot Tuba [ Ultra -low Volume Flush Toileta :[ :y other'.(SpeoLEI, ) APPLICANT'S SIGNATURE: DR 4015, 10/97 (Previous Editions�May.Bail'Tsed)`,. f U AJP JOB#: 05-0099 c ] Floor/Equipment Drains DATE: 3-11-05 Page 1 of 3 10/15/2019 eBr4ge'Web Viewer previous c7�� } Page 6 of 18 STATE OF FLORIDA CENTRAY #; 56-SF-08244 DEPARTMENT OF HEALTH OSTDSNBR : 05-0331-N ONSITE SEWAGE DISPOSAL SYSTEM ..®N SITE EVALUATION AND SYSTEM SPECIFICATIONS APPLICANT: Smffio, Tony AGENT; ALFJMNDRR PIAZZA LOT: 2 BLOCK: 87 SUBDIVISION: Lakewood Park ID#: TO.BE COMPLETED BY ENGINEER, MOST PROVIDE REGTSTRATTON MMER HEALTH DEPARTMENT EMPLOYEE, AND SIC: AND SPAT RAM PACUP, OR OTHER QUALIFIED PERSON. ENGINEER'S OF SUBMITTAL,— OM 7 A7L 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 [64E-6, TABLE 11 . AUTHORIZED SEWAGE FLOW: 4D5 GALLONS PER DAY [1500GPD/ACRE OR 2500GPD/ACRE] UNOBSTRUCTED AREA AVAILABLE: 1231 SOFT UNOBSTRUCTED AREA REQUIRED: 1143 SOFT BENCHMARK/REFERENCE POINT LOCATION: C/L of Road Center of Lot ELEVATION OF PROPOSED SYSTEM SITE IS 17.00 [ INCHES ] [ ABOVE ]BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER: 50 FT DITCHES/SWALES• 15 FT NORMALLY WET? [ ]YES [ Z ]NO WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: 75 FT NON -POTABLE: N/A FT BUILDING FOUNDATIONS: 3.0 FT PROPERTY LINES: 10 FT POTABLE WATER LINES: 10 FT SITE SUBJECT TO FREQUENT FLOODING: [ ]YES [ X ]NO 10 YEAR FLOODING? [ ]YES [ 3: ]NO 10 YEAR FLOOD ELEVATION FOR SITE: 0 FT NGVD SITE ELEVATION: 0 ' FT NGVD SOIL PROFILE INFORMATION SITE I Muneell #/Color Texture Depth I nyR-S/1-ay Ping RanA R t0 1f. ]dyR-4/2-R7 AN Ping RanA 19 t0 24 inyR-4/1..7: ny Ping an"A3, n. _ 24 t0 49 1AYR-fill-my Ri Tq R.nA _4R to 54 1 OVR-6/1-av _ RafUAal R4 t0 77 t0 t0 USDA SOIL SERIES: 4 Areate t0 SOIL PROFILE INFORMATION SITS 2 Munsell #/Color' Texture 1::yR-:'y/7_(4y Ping RanA Depth a to 1R inyg-5/2-m nw Pin. RanA 1R t6 24 inyp-4/1-n or Pin. Ramdy I.n 74 to 42 1nyg_g/1-i3y Pins RnnA 49. to 4R 10YR-6/1-GY R.Fx+awl 4R to t0 t0 to USDA SOIL SERIES: 4 Arenta OBSERVED WATER TABLE: 36.00 INCHES [ BELOW ] EXISTING GRADE TYPE: [APPARENT ] ESTIMATED WET SEASON WATER TABLE BLEVATION:35.00 INCHES [ BELOW ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: I ]YES [XI NO MOTTLING: [ ]YES [ZINO DEPTH: 0.0 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING:Fine Sand/0.70 DEPTH OF EXCAVATION:84.0 INCHES DRAINFIELD CONFIGURATION: [ ]TRENCH I X ]BED [ ]OTHER (SPECIFY] REMARKS/ADDITIONAL CRITERIA: SITE EVALUATED BY: JAMES DUNCAN 'DATE: 6/7/05 DH 4015, 03/97 (Obeoletee Previous editions Which may not be used) (Stock Number: 5744-003-4015-1) [ostda_eval_4015-3] Page 3 of 3 WHV 80CDs... 10/ 15/2019 eBricfge'Web Viewer �g�r V W�� Ap Page 15 of 1 STATE OF FLORIUA PERMIT APPLICATION TO CONSTRUCT, '� pcc R6 MODIFY. ORARANODN AWELL �u NoRrwri 1tfC♦,1'ORM lbtrtriAF0.LmOlR00�aGlYPlr, TM.i4rr.ae.�ty.�rM1rpiOnld.lelcVyy4l�tld. rBLmrot s rows a.etuWur�e�eDeepe mYbt» .tedekOkM ; Guam" i, $aamiw Rhsr toWyt.unymgrttry, ��P mRaRaWlroRwpROPRY1749WtRtar 1. S f. t6a�,,,� K 9184oCa+i.t. f. NWrtq OSP�DalaaWtlM�� � Gaeak mows a? wat`SDam"We Dia. NMQ _Ucrap �krlQdtonteuelrstl, �F2onawmersu�P4muAMqu—LnlVtlur-. S. mm�vwlv Y. 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