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Home My WebLink AboutD.O.H. PAPPERWORKSTATE OF FLORIDA DEPARTMENT OF HEALTH �C� ONSITE SEWAGE TREATMENT AND DISPOS*e 2b SYSTEM pp 1-0 SCANNED St. let, o 1p19 St. Lucie County APPLICATION #:AP1450589 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1284272 CONSTRUCTION PERMIT FOR: OSTDS New File COPY APPLICANT: (Adams Homes of Northwest Florida, Inc) PROPERTY ADDRESS: 5705 Cassia Dr Fort Pierce, FL 34982 LOT: 25 PROPERTY ID #: BLOCK: 78 SUBDIVISION: Indian River Estates 3402-610-0250-000-3 [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 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 [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps D [ 375 1 SQUARE FEET Drainfield New SYSTEM R ( ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X] MOUND I CONFIGURATION: [X] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: Orange spot C/R center Of property I ELEVATION OF PROPOSED SYSTEM SITE [ 3.00 1 [1 INCHESFT I ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 3.00 ][ INCHES FT ][ ABOVE BELOW]SENCHMARK/REFERENCE POINT L D 0 T H E R system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of gpd. SPECIFICATIONS BY: Dianna S _i TITLE: Environmental Supervisor I APPROVED BY: TITLE: Environmental Supervisor I $f. Lucie CHD Dianna s May DATE ISSUED: 12/1012019 EXPIRATION DATE: 06/10/2021 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 NU I K:t OF K1UHTS t 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 r 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. I- 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. n St. Lucie County Health Department 5}� 5150 NW Milner Dr PortSaint Lucie, FL 34983 HEALTH PAYING ON: #:56-SF-2012249 BILL ooc#56-BIDA468633 CONSTRUCTION APPLICATION #:AP1450589 RECEIVED FROM: Benjamin Drew"s Plumbing & Drain Ser AMOUNT PAID: $ 545.00 PAYMENT FORM: CHECK 189313 PAYMENT DATE: 10/29/2019 MAIL TO: (Adams Homes of Northwest Florida, Inc) FACILITY NAME: PROPERTY LOCATION: 5705 Cassia Dr Fort Pierce, FL 34982 25 78 Lot: Block: Property ID: 3402-610-0250-000-3 EXPLANATION or DESCRIPTION: 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-4210920 �M STATE OF FLORIDA PERMIT NO.!Sk--,,OI��q DEPARTMENT OF HEALTH DATE PAID: p ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: SYSTEM I RECEIPT #: CC'-*j2q'. tS APPLICATION FOR CONSTRUCTION PERMIT Ap�PLICATION FOR: [�(] New System [ j Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT: AGENT: MAILING ADDRESS: TELEPHONE: -172' O �n �ZaLOZ TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 989.105 (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: 2S BLOCK: p SUBDIVISION: [��f� Y j! &}Q-}C.0 PLATTED: I /S� 4 �1} PROPERTY ID #: 3`(�Z•Le 10-DZ&1[2-DM-3 ZONING: I/M OR EQUIVALENT: [ Y /® PROPERTY SIZE: ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC L�/]<=2000GPD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y / ND DISTANCE TO SEWER: wI FT � i' PROPERTY ADDRESS: _MQQsSIa ��. F+. �I Cj2 e 1 C �� J DIRECTIONS TO PROPERTY: CeQ�(�� BUILDING INFORMATION Unit Type of No Establishment ARESIDENTIAL [ ] COMMERCIAL No. of Building 'Commercial/Institutional System Design Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC z dQn3;a0 — 2o1D 4M (7-i x L 3 4' [ ] Floor/Equipment SIGNATURE: [ ] Other (Specify) DATE: z2.I o DH 4015, 08/09 (Obs`T&fes Pius editions which may not be used) Incorporated 64E-6.001, FAC Page 1 of 4 STATE OF FLORIDA APPLICATION # so DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM PERMIT # 56-SF-2012249 SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT If SE1233110 APPLICANT: Adams Homes of Northwest Florida, Inc CONTRACTOR / AGENT: Benjamin Drew"s Plumbing & Drain Services LOT: 25 BLOCK: 78 SUBDIVISION: Indian River Estates ID#: 3402-610-0250-000.3 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: 0.23 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 575.01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 588.00 SQFT UNOBSTRUCTED AREA REQUIRED:-563.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: center of ELEVATION OF PROPOSED SYSTEM SITE 3.00 [ INCHES / FT ] [ ABOVE / BELOW ] BENCHMARN/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: PT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT SITE SUBJECT TO FREQUENT FLOODING? 10 YEAR FLOOD ELEVATION FOR SITE: AnTT. PRn17TT.R TNFr1RMamTnl ATmc 1 PROPERTY LINES: 11 FT POTABLE WATER LINES: 30 FT [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES IX]NO] FT I MSL / NGVD ] SITE ELEVATION: FT I MSL / NGVD USDA SOIL SERIES:Lawnwood sand Munsell #/Color Texture Depth 10YR 3/3 Sand 0 To 8 1 OYR 5/1 Sand 8 TO 25 1 OYR 6/1 Sand 18 To 36 10YR 4/2 Sand 36 To 46 1 OYR 211 Spodic Material 46 To 50 REFUSAL Refusal 50 To 50 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES:Lawnwood sand Munsell #/Color Texture Depth 10YR 3/3 Sand 0 To 8 10YR 5/1 - Sand 8 To 25 10YR 6/1 Sand 18 To 36 10YR 412 Sand 36 To 46 10YR 211 Spodic Material 46 To 50 REFUSAL Refusal 50 TO 50 OBSERVED WATER TABLE: 22.00 INCHES [ ABOVE / BEIAW ] EXISTING GRADE TYPE: ESTIMATED WET SEASON WATER TABLE ELEVATION: 18 INCHES [ ABOVE / BELOW] HIGH WATER TABLE VEGETATION: [ ]YES [X ]NO MOTTLING: IX IYES [ ]NO [ PERCHED / APPARENT ] EXISTING GRADE DEPTH: 18.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: [XI TRENCH [ ] BED [ ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA L' WSWT determined using USDA WSS and soil borings.10YR611 stripping in a 10YR511 matrix>10% with diffused boundaries starting at 18" in SB1. SBI and SB2 T below BM. SITE EVALUATED BY: z Aa� DATE: May, Dianna (Title: Envlmn ntal Supervisor 1) (Florida Department of Health in St Lu DR 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC INCHES 12/05/2019 Page 3 of 4