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SPANNED'
BY
st Luc leCounty,
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NOTICE: OWNER/BUILDERS
O'ldNER/BUILDERS OF ONE OR TWO—FAMILY UNIT DWELLINGS, OR COmmER—
CIAL BUILDINGS UNDER $25,000.00 IN VALUE, ARE EXEMPT FROM THE
REGULATIONS AS SET FORTH IN FLORIDA STATUTES 468 WHEN BUILDING
FOR THEIR OWN USE AND OCCUPANCY ONLY.
THE SALE OR LEASE, OR OFFERING FOR SALE OR LEASE, OF SAID
6 STRUCTURE IS A CRIMINAL VIOLATION PUNISHABLE AS A MISDEMEANOR
OF THE SECOND DEGREE.
IN ADDITION, IF THE OWNER/BUILDER DOES SELL OR LEASE THE DWELL—
ING, HE MAY SUBJECT HIMSELF TO A CIVIL LAW SUIT.
I HEREBY ACKNOWLEDGE THAT I'HAVE READ AND UNDERSTAND THE ABOVE
NOTICE ON THE /�r�� DAY OF ��� 19717: SCANNED
BY
St. Lucie County
J� oy ��--
OWNER/BUILDER
z�nlication/Permit
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....,,.,:...;
., No.
Health : Dep
County artment,
` :.DEPARTMENT -OF HEALTH AND REHABILITATIVE SERVICES -
- DIVISION
OF HEALTH SCANNED
Application and,Permit BY
of
Individual Sewage
Disposal Facilities St. Lucie County' '
Section I- Instructions:.
-.
1. Percolation test 'data, soil pro-
5. Indicate'name and ,date of
file and water table elevation-
recording of subdivision. If `
information must be attached.
not recorded, attach metes'and
(Note: Test must be made at
bounds description.
proposed location.of� system).
6,. Complete -the following.infor-
2. Existing.building and proposed
mation section.'
buildings on lot Must be shown
and drawn to'. at'their
Notes;
location or proposed location.
1. Not valid i£+sewer is available.
(Use block on this sheet or
2. Individual°well must be 75 feet
attach`plot plan):
from any part of system.
3. Proposed location,of septic
3. Call 46175350 and give
tank must be shown on plan'.
ulis office a 24-hour notice
4. Any pond or stream areas must
when ready'for inspection.
be indicated on the plan.
' Section II - Information.:.
1. Property Address (Street & House No.)
Oak Drive
Lot 4 28 Subdivision
Ft..Pierce Shores Revised Map
_Block
Date Recorded 12-28-51) Directions to
Job South on Atlantc=Beach Blv . West
on Banyan
Rd. South on Oak Drive about
210 feet lot on left
2. Owner
r Builder Robert Boyd
P.O. AOress
a301 Oleander City Ft. Pierce, Fl
3. Specification§
Tank
- Drainfield
scale 1" = 50'
Gals. ft. of 6" clay tile
, or 5" perforated'
(Rear)
plastic drain in a
•
Gals
3' trench or
3(Jp ft. of 4" clay drain
z
,or 4" perforated
m
"plastic drain in an
M
18" trench
m
4. House to be constructed:
rt
' - Check one: -FHA,
m
' ,VA X Conventional
't
�—
n
This is,to certify ,that the project
rt
described,in
this application, and as
SD
detailed by
the plans and specifica-
tions and attachments will be'con-
w
structed in accordance with state
requirements.
" �Applicant- R h- rt Rn d
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Please Print,.. • .(Name of Street or State Road)
Signature:' Date February 2 1979
DO .NOT WRITE BELOW THIS LINE
Section III.- Application Approval & Construction Authorization
Installation `subject tb followifia, special' condiitions:
�o �n 501 lC) LO6oe Q?ead Grcow / '•,,
The abovetsigned:application hag`1>en found to be in compliance with Chapter 17-13',
Fl ida Admini ra,ive Code, and construction is hereby approved, subject'tc�the
ab ve speci.fi a is d conditions, c�
+ By: _ County Health Dept .s J �ji c, ,�,Datea/a7-g— .
Section IV - Final; Construction Approval -
Con' ruction of installation approved,: Yes No
Dat ::, By;
FHA No. .VA No., -
TEMPORARY _
+r SAN 428 \J
•- REV. 7/l/73
F-2% TaaalA 6 Ft" Praltitil, irK; Fr, Nerw.. Fla.