HomeMy WebLinkAboutD.O.H. PAPPERWORKY-m 1
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
PERMIT #:56-SF-2008516
APPLICATION #:AP1448325
DATE PAID:
FEE PAID:
RECEIPT #:
bile Copy DOCUMENT #: PR1279634
SCANNED
BY
CONSTRUCTION PERMIT FOR: OSTDS New St. Lucie County
APPLICANT: (Adams Homes of Northwest Florida Inc)
PROPERTY ADDRESS: 5609 Birch Dr Fort Pierce, FL 34982
LOT: 40 BLOCK: 56 SUBDIVISION: Indian River Estates
PROPERTY ID #: 3402-60M178-000-0 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAR 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 THISPERMIT 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 8[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 500 ] SQUARE FEET Drainfield new SYSTEM
R [ 1 SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X] MOUND [ ]
I CONFIGURATION: [X] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: FND IR in cut -Out, Center Of intersection
I ELEVATION OF PROPOSED SYSTEM SITE [ 3.00 1 [1 INCHES FT I [I ABOVE BELOW] BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 6.00 ][INCHES FT ][ AEOVE BELOW] BENCHMARK/REFERENCE POINT
L
F7
Z1
T
H.
E
R
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: rian J Ingr
TITLE: Environmental Specialist
II
APPROVED 13y;42
TITLE: Environmental Specialist II
St. Lucie CED
Brian J InAn
DATE ISSviaD:
11/04/2019
EXPIRATION DATE:
05/04/2021
DH 4016. 08/09
(Obsoletes all previous
editions which may not be used)
InCO*03ceLted:
64E-6.003, FAC
Page 1 of 3
v 1.1.4
AP1448325 SE1228447
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.
Forl"
HEALTH
PAYING ON:
RECEIVED FROM:
PAYMENT FORM:
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
a 56-SF-2008516 BILL ooc o.56-BID-4460215 CONSTRUCTION APPLICATION N: AP148325
Beniamin Drew"s Plumbinq & Drain Ser AMOUNT PAID: $ 545.00
CHECK 181783 PAYMENT DATE: 10/15/2019
MAIL TO: (Adams Homes of Northwest Florida, Inc)
FACILITY NAME:
PROPERTY LOCATION:
5609 Birch or
Fort Pierce, FL 34982
40
Lot:
Property ID: 3402-609-0178-000-0
EXPLANATION or DESCRIPTION:'
56
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 AUDIT CONTROL NO. 56-PID-4199308
4 STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[�(] New System [ ] Existing System [ ] Holding Tank
[ ] Repair [ ] Abandonment [ ] Temporary
PERMIT N0.5 - �W V.71�
DATE PAID: S
FEE PAID: UC-
RECEIPT #:
[ ] Innovative
APPLICANT: �d0.mS �[Y1PC d�' �(�Y)PS•% �L
AGENT: j� \nI Yec.U�S RIAM10 )00 TELEPHONE:IIZ-
MAILING ADDRESS: 4I1�JGYY�\ .� c�lvG�.._ JJ'Fi-. Pierce , FL -Wt r l
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 (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS.
PROPERTY INFORMATION
LOT: 40_ BLOCK: GAY SUBDIVISION: jnlnat�,afi Cvet T�S+CC�CSPLATTED: �y�w
u-ht t 8
PROPERTY ID n:3�E02 - �Q(�-(71'1$•DDU-D ZONING: PS-_ I/M OR EQUIVALENT: [ Y / NO
PROPERTY SIZE: D.3 ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [✓J<=2000GPD [ ]>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y /a
DISTANCE TO SEWER: _AFT
PROPERTY ADDRESS: oct CJ\yGi-, DY -yc- 1F+P l -e,Ycrc
DIRECTIONS TO PROPERTY: S-e-e a4+Ci(C-yYP(1 rf�OXQ
BUILDING INFORMATION [XI RESIDENTIAL [ ] COMMERCIAL
Unit Type of No. of Building Commercial/Institutional System Design
No Establishment Bedrooms Area Sq£t Table 1, Chanter 64E-6, FAC
1 QE5� ol�tn'�0.0 O D A W q
2
3
4
[ ] Floor
SIGNATURE:
] Other (Specify)
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC.
DATE: jo--) Iq
Page 1 of 4
STATE OF FLORIDA APPLICATION # AP1448325
DEPARTMENT OF HEALTH PERMIT # 56-SF-2008516
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DocuMENT # SE1228447
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Adams Homes of Northwest Florida, Inc
CONTRACTOR / AGENT: Benjamin Drew"s Plumbing & Drain Services
LOT: 40 BLOCK: 56
SUBDIVISION: Indian River Estates ID#: 3402-609-0178-000-0
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: EX ]YES [ ]NO NET USABLE AREA AVAILABLE: 0.30 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY IF RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 750.00 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 LOCATxON: FNDIRin
ELEVATION OF PROPOSED SYSTEM SITE ann
FT ] [ ABOVE / BELOW ] BENCHMAHK/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: 100 FT NON -POTABLE:
100 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
[XINO]
10 YEAR FLOOD ELEVATION FOR SITE:
FT[ MSL / NGVD I
SITE ELEVATION: FT [ MSL / NGVD
B07T. 9Rl1FTT.0
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
1 OYR 4/1
Sand
0 To 4
1 OYR 511
Sand
4 To 15
1 OYR 6/1
Sand
15 To 30
10YR 7/1
Sand
21 To 41
IOYR 2/1
Spod[c Material
41 To 63
10YR 4/3
Sand
63 To 72
vnm Tnla CTTF. 2
VUSDA SOIL SERIES:
Munsell #/Color
Texture
Depth
10YR 4/1
Sand
O To 6
IOYR 511
Sand
6 To 16
1 OYR 611
Sand
16 To 43
1 OYR 711
Sand
24 To 43
I OYR 2/1
Spodic Material
43 To 61
1 OYR 313
Sand
61 To 68
10YR 4/3
Sand
68 To 72
OBSERVED WATER TABLE: 36.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 21 INCHES ( ABOVE / EELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: ( ]YES EX ]NO MOTTLING: IX]YES ( ]NO DEPTH: 21.00 INCHES
SOIL TEXTURE/LOAbING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: INCHES
DRAINFIELD CONFIGURATION: [XI TRENCH [ ] BED [ ] OTHER (SPECIFY)
r REMARKS/ADOZTIONAL CRITERIA
WSWT determ[ned Vs]ng USDA WSS and soil borings-
10YR7/1 stripping ih 10YR611 matrix >16% with diffuse boundaries starting at 21" in SB7
SB7 3" abOveaM, SB24" above BM. i?
SITE EVAL%171lj BY: / DATE: 10/28/2019
Ingram, Brian (TI : Environmental Specialist II) (ENVIRONMENTAL HEALTH)
DR d015, Oa/09 (Obsolutea Page 3 of 4
previous erHtiona w cT may not be used) Incorporated: 6dE-6.001, FAC 4
APJ448325 EID2008516 v 1.0.2
rroperty vara
Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved.
Property Identification
Site Address: 5609 BIRCH Parcel ID: 3402-609-0178- Account #: 37732 SecrFown/Range:
DR 000-0 11/36S/40E
Map ID: 34/1 IN Zoning: RS-4 Count Use Type: 0000 Jurisdiction: Saint Lucie
County
Ownership Legal Description
Adams Homes of Northwest Florida Inc INDIAN RIVER ESTATES-UNIT-08- BLK 56 LOT 40 (MAP
3000 Gulf Breeze PKWY 34/1IN)
Gulf Breeze, FL 32563
Current Values Historical Values 3-year
Just/Market:
$15,400 Assessed: $10,450 Year Just/Market Assessed Exemptions
Taxable
Exemptions:
$0 Taxable: $10,450 2019 $15,400 $10,450 $0
$0
$10,450
$9,500
2018 $13,100 $9,500
2017 $12,300 $8,637 $0
$8,637
Sale History
Date
Book/Page Sale Code Deed Grantor -
Price
04-23-2019
4260 / 2804 0001 WD Rodriguez -Ricardo
$27,000
$33,000
04-28-2004
1963 / 1627 XX00 WD Thomas Diane
$19,500
10-29-2003
1835/2183 XX00 WD Becker Alexander
Primary Building Information
Finished Area of this building: 0 SF
Gross Sketched Area: 0 SF
Exterior Data
View:
Roof Cover: Roof Structure: Building Type:
Year Built: N/A
Frame: Grade: Effective Year: N/A
Primary Wall:
Story Height: No. Units: 0 Secondary Wall:
Interior Data
Bedrooms: 0
A/C %: 0% Electric: Primary Int Wall:
Full Baths: 0
Heated %: N/A% Heat Type: Avg Hgt/Floor: 0
Half Baths: 0
Sprinkled %: 0% Heat Fuel: Primary Floors:
Total Areas
Finished/UnderAir
0
(SF):
Gross Sketched Area
0
(SF):
. Land Size (acres):
0.3
f
*
Land Size (SF): 13,125
5. Total Building Count:
1
Type
Special Features and Yard Items
Qty Units Year Blt
All information is believed to be correct at this time, but is subject to change and is provided without any warranty.
0 Copyright 2019 Saint Lucie County Property Appraiser. All rights reserved.
https://www.pasle.org/RECard/ 10/15/2019
9/8/2019
5609 Birch Dr - Google Maps
Go,,..gle Maps
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Map data @2019 1000 ft-
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1447 a,
Custom Soil Resource Report
St. Lucie County, Florida
21—Lawnwood and Myakka sands
Map Unit Setting
National map unit symbol., ljpvg
Elevation: 20 to 200 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: Farmland of unique importance
Map Unit Composition
Lawnwood and similar soils: 40 percent
Myakka and similar soils: 40 percent
Minor components: 20 percent
Estimates are based on observations, descriptions, and transacts of the mapunit.
Description of Lawnwood
Setting
Landform: Marine terraces on flatwoods
Landform position (three-dimensional): Talf
Down -slope shape: Linear
Across -slope shape: Linear
Parent material. Sandy marine deposits
Typical profile
A - 0 to 8 inches: sand
E - 8 to 28 inches: sand
Bh 1 - 28 to 52 inches: sand
Bh2 - 52 to 58 inches: sand
C - 58 to 80 inches: sand
Properties and qualities
Slope: 0 to 2 percent
Depth to restrictive feature: 10 to 31 inches to ortstein
Natural drainage class: Poorly drained
Runoff class: 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
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 0.9 inches)
Interpretive groups
Land capability classification (irrigated): None specified
Land capability classification (nonirrigated): 4w
Hydrologic Soil Group: A/D
Forage suitability group: Sandy soils on flats of mesic or hydric lowlands
(G156BC141FL)
10
Custom Soil Resource Report
Hydric soil rating: No
Description of Myakka
Setting
Landform: Flatwoods on marine terraces
Landform position (three-dimensional): Talf
Down -slope shape: Convex
Across -slope shape: Linear
Parent material. Sandy marine deposits
Typical profile
A - 0 to 7 inches: sand
E - 7 to 27 inches: sand
13h - 27 to 38 inches: sand
C - 38 to 80 inches: sand
Properties and qualities
Slope: 0 to 2 percent
Depth to restrictive feature: More than 80 inches
Natural drainage class: Poorly drained
Runoff class: High
Capacity of the most limiting layer to transmit water (Ksat): Moderately high to
high (0.57 to 5.95 in/hr)
Depth to water table: About 6 to 18 inches
Frequency of flooding: None
Frequency of ponding: None
Salinity, maximum in profile: Nonsaline to very slightly saline (0.0 to 2.0
mmhoslcm)
Sodium adsorption ratio, maximum in profile: 4.0
Available water storage in profile: Low (about 4.5 inches)
Interpretive groups
Land capability classification (irrigated): None specified
Land capability classification (nonirrigated): 4w
Hydrologic Soil Group: A/D
Forage suitability group: Sandy soils on flats of mesic or hydric lowlands
(G156BC141FL)
Hydric soil rating: No
Minor Components
Ankona
Percent of map unit., 7 percent
Landform: Flatwoods on marine terraces
Landform position (three-dimensional): Talf
Down -slope shape: Convex
Across -slope shape: Linear
Hydric soil rating: No
Electra
Percent of map unit: 7 percent
Landform: Rises on marine terraces, knolls on marine terraces
Landform position (three-dimensional): Interfluve
Down -slope shape: Convex
Across -slope shape: Linear
Hydric soil rating: No
11
Custom Soil Resource Report
Waveland
Percent of map unit: 6 percent
Landform: Flatwoods on marine terraces
Landform position (three-dimensional): Talf
Down -slope shape: Convex
Across -slope shape: Linear
Hydric soil rating: No
12
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