HomeMy WebLinkAboutD.O.H. PAPPERWORKSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
SCANNED
BY
St. Lucie County
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Charles Timmons
PROPERTY ADDRESS: 10603 Pine Needle Dr Fort Pierce, FL 34945
PST #:56SF-1988105
APPLICATION #:AP1432154
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1253286
LOT: 26 BLOCK: SUBDIVISION: Pine Hollow
PROPERTY ID #: 2321-802-0028-000-6 [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 TEE
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 Seotic New CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXJX M CAPACITY SINGLE TANK:1250 GALLONS]
R [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 BRS #Pumps [
D [ 500 ] SQUARE FEET
R [ ] SQUARE FEET
A TYPE SYSTEM: [ ]
I CONFIGURATION: [X]
N
F LOCATION OF BENCHMARK:
Drainfleld New SYSTEM
N/A SYSTEM
STANDARD [ ] FILLED [X] MOUND [ ]
TRENCH [ ] BED [ ]
Site BM NID CL of old FFA Road
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: r22 on7 rwrwve
0
T
H
E
R
[ 4.00 ] [INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
[ 0.00 1 [FINCHEST FT IABOVE BELOW] BENCHMARK/REFERENCE POINT
system Is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow ofgp
o,9
d. NoV ral G-00
♦ 0
SPECIFICATIONS Hunter A Collier EME TITLE: Environmental Specialist I
APPROVED BY: TITLE: Environmental Specialist I St Lucie CHD
Hunter A Collier
DATE ISSUED: 09/20/2019 EXPIRATION DATE: 03/20/2021
OR 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, SAC Page 1 of 3
v 1.1.4 AP1432154 SE1202299
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Charles Timmons
CONTRACTOR / AGENT: DIFranceslo Construction Inc.
APPLICATION # AP1432154
PERMIT # 56SF-1988105
DOCUMENT # SE1202299
LOT: 26 BLOCK:
SUBDIVISION: Pine Hollow ID#: 2321-802-0028-000-6
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MOST PROVIDE
REGISTRATION NUMBER AND SIGN AND SEAL BACK PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES I ]NO NET USABLE AREA AVAILABLE: ' 1.05 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 1676.00 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1000.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1000.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Site BM NID CL of old FFA Road
ELEVATION OF PROPOSED SYSTEM SITE 4.00 [ INCKES / FT ] I ABOVE / BELOW ] BENCHMARK/REFERZNCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: FT DITCHES/SWALES: FT NORMALLY WET: I ]YES [X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE. 90 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 7 FT PROPERTY LINES: 10 FT POTABLE WATER LINES: 75 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES IX]NO 10 YEAR FLOODING? I ]YES [X]N01
10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL /'NGVD ] SITE ELEVATION: FT [ MSL / NGVD
SOIL PROFILE TNFORMATTOAI ATTR 1 SOTT. DRr1F'TT.F. TWMRMATTON STTR. 7
USDA SOIL SERIES:
Munsell#/Color
Texture
Depth
1OYR 5/1
Sand
0 To 12
10YR 6/2
Sand
12 To 26
IOYR 7/2
Sand
17 To 30
1 OYR 4/1
Sand
30 To 33
1 OYR 3/2
Sand
33 To 37
1 OYR 2/1
LoamySand
37 To 46
1 OYR 5/3
Sandy Loam
46 To 57
1 OYR 5/2
Loamy Sand
57 To 68
10YR 4/2
Sand
68 To 72
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
I OYR 6/1
Sand
0 To 12
1 OYR 6/2
Sand
12 To 17
1 OYR 7/2
Sand
17 To 30
1 OYR 4/1
Sand
30 To 33
1 OYR 312
Sand
33 To 37
1 OYR 211
Sand
37 To 46
1 OYR 5/3
Loamy Sand
46 To 57
1 OYR 512
Loamy Sand
57 To 68
10YR 412
Sand
68 To 72
OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 20 INCHES [ ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES EX ]NO MOTTLING: [X]YES [ ]NO DEPTH: 20.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: INCHES
DRAINFTET.n CONFIGURATION: [X ] TRENCH I ] BED [ ] OTHER (SPECIFY)
r RF.MARxs/ADDITIONAL CRITERIA
SWT determined using USDA WSS and soil borings. 10YR 712 stripping In 10YR 612 matrix> 10%with diffuse boundaries starting
20" in SB1. SB14" below SM. S1321" below BM.
SITE EVALUATED BY: U A A J� �/ \1 �Yk �� DATE: 09/18/2019
Co Iler, Hunter (nue: Environmental Specialist 1) (Florida Department of Health In St. L
De 4015, 08109 (obsoletes province editions which say not be used) Incorporated: 64E-6.001, FAC Page 3 of 4
AP1432154 EID1988105 v 1.0.2
i
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
W1eu- No.5cl-aa9a-(
PERMIT NO. NQ-!51-1C(9 106
DATE PAID: q
FEE PAID: - �'-101
RECEIPT #:
APPLICATION FOR:
('v(I New System [ ] Existing System ( J Holding Tank [ ] Innovative
[ ], Repair [ ] Abandonment [ ] Temporary ( J
APPLICANT: (j, �,�j_t5 1 )-)"n Mons 4- �. iffY14(4. iM9th'n'
AGENT: .lii'rFr&:,74rStU eLn,,,:s,+e cjnr) 3:,Ae- vvaa'G. w,l D7 Frav,c-z5,-o TELEPHONE: 7%2- Zbi `17y7
,
MAILING ADDRESS, 39[(U �a:nzSArn� �:nt_ 'il'»'L ,F..\ p:r;z2 (_i-
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
APPLICANTeS RESPONSIBILITY TO PROVIDE DOCOMENTATION OF THE DATE THE LOT WAS CREATED OR
PLATTED '(MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS.
P40PERTY'INFORMATION'
LOT: BLOCK. SUBDIVISION: Pm4 )+ylje�3 ::n;i 2- PLATTED:
PROPERTY ID #, '�j-'j%0,2- o^C) $ i�pjo ZONING: I/M OR EQUIVALENT: [ Y/N ]
PROPERTY SIZE: J'O S ACRES WATER SUPPLY: [ ✓] PRIVATE PUBLIC L� ]c=2000GPD [ 1>2000GPD
IS. SEWER AVAILABLE AS PER 381..0065r FS? [ Y/ jl' ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: ��� "•Z �S»2 ne c Q.I P .� 'v8. FT' f?C' t FL 34', tf
DIRECTIONS TO PROPERTY: Levi Q dt jU N ox," '}n Pico S 12-0 ) c TT oil o S
-_2; „s is ki) RT- kL etc .
.BUILDING INFORMkTION [ J RESIDENTIAL [ J COMMERCIAL
Unit Type of No, of Building Commercial/Institutional System Design
N4 'Establishment Bedrooms Area Saft Table 1, Cbapter 64E-6., PAC
s, a. 9
2
3
4
[/ti] Floor/Equipment Drains
SIGNATURE;
J Other (Specify)
DH 401.5, 05109 (Obsoletes previous* editions which may not be used)
Incorporated 64E-6.001, PAC
DATE: Yo Scg- 2,N q
Page 1 of 4