HomeMy WebLinkAboutDOH PAPPERSSCANNED
BY
STATE OF FLORIDA St. Lucie County PERMIT NO.
s DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID:
SYSTEM RECEIPT #: r
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[ ] New System [ ] Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair
''nn 11 [ ] Abandonment [ ] Temporary [ ]
APPLICANT: ii l,Nl'l� com
AGENT: U/SI6, \ TELEPHONE:221
MAILING ADDRESS: J(D� in[. 6, St^i(-G /Y/o%icwxt V/_ Z2e/O/
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: GL SUBDIVISION: PLATTED:
PROPERTY ID #: ZONING: I/M OR EQUIVALENT: [ Y/® ]
PROPERTY SIZE: I.I.Q ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [;(1<=2000GPD [ ]>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y/O] ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: V?0t) ',H(/1AS6rjj .3.?i� Sk. �J-�-QrL f pj-l-�
r.(L scog y
DIRECTIONS TO PROPERTY: .j..- 9$r .� e - 'Lnr-"Al OAST) .4-,,, 6aA 'n ^ tl?- -^+
�A�- �omti� 1230
BUILDING INFORMATION
Unit Type of
No (Establishment
I
2
3
4
[ ] RESIDENTIAL [ x] COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
[ ] Floor/Equipment Drains [ ] Other (Specify)
SIGNATURE:
�lCBIiG�Wc�S M K062_
DATE:
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
STATE OF FLORIDA APPLICATION # AP1229681
DEPARTMENT OF HEALTH PERMIT # 56-SF-02480
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEMSCAN NED DOCUMENT # SE989161
SITE EVALUATION AND SYSTEM SPECIFICATION BY
St. Lucie County
APPLICANT: William.
CONTRACTOR / AGENT:
LOT: 1-27
William
BLOCK: 64 &65
SUBDIVISION: ID#: 1428-702-1501-000-1
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: IX]YES [ ]NO NET USABLE AREA AVAILABLE: 4.74 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 585 GALLONS PER DAY [ I RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 11849.98 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1500.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1462.50 SQFT
BENCHMARK/REFERENCE POINT LOCATION: BM paint Comer Of transformer pad
ELEVATION OF PROPOSED SYSTEM SITE 17.00 [ INCBES / FT ] [ ABOVE /
BENCHMARK/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: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT
BUILDING FOUNDATIONS: FT PROPERTY LINES: 5 FT - POTABLE WATER LINES: FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]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:Penda is sand
Munsell #/Color Texture
Depth
10YR412
FII - Sand
0To 14
10YR 211
Loamy Sand
14 To 27
1 OYR 4/1
Sand
27 To 31
1 OYR 6/1
Sand
31 To 38
1 OYR 2/2
Spodic Material
38 To 45
1DYR 3/3
Sand
45 To 57
7.5YR 4/6
CMN/PRM RF
54 To 57
10YR 212
Loamy Sand
57 To 72
USDA SOIL SERIES:Pendarvis
Munsell #/Color
sand
Texture
Depth
1 OYR 4/2
Fill - Sand
0 To 14
10YR 2/1
Loamy Sand
14 To 27
10YR 4N
Sand
27 To 31
10YR 6/1
Sand
31 To 38
1 OYR 2/2
Spodic Material
38 To 45
1 OYR 3/3
Sand
45 To 57
7.5YR 416
CMN/PRM RF
54 To 57
10YR 2/2
Loamy Sand
57 To 72
OBSERVED WATER TABLE: 65.00 INCHES [ ABOVE
/ ELOW 3 EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION:
54 INCHES
[ ABOVE / EELOW ]
EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO
MOTTLING:
[X]YES [ ]NO DEPTH:
54.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING:
Sand/0.60
DEPTH OF EXCAVATION:
45 INCHES
DRAINFIELD CONFIGURATION: [ ] TRENCH [X ] BED [ ] OTHER (SPECIFY)
IS
REMARKS/ADDITIONAL. CRITERIA I
SWT determined using USDA WSS and soil borings.
ommon prominent redox features 7.5YR416 mottles in 10YR313 matrix @ 54" in both borings.
B 1 and SB 217" below BM
SITE EVALUATED BY:
Ingram Ran (Title: Environmental Specialist 1) (ENVIRONMENTAL HEALTH)
DE 4015, 08/09 (Obsoletes previous edit ns which may not be used) Incorporated: 64E-6.001, PAC
DATE: 03/16/2016
Page 3 of 4
AP1229681 EID344269 v1.0.2
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
SCANNED
BY
St. Lucie County
CONSTRUCTION PERMIT FOR:
APPLICANT: William Aldridl
PROPERTY ADDRESS: 290
LOT: 1-27
PERMIT
0
STDS New
33rd St Fort Pierce, FL 34946
64 &65 SUBDIVISION:
PROPERTY ID #: llp-7702-1501-000-1
PERMIT #: 56-SF-02480
APPLICATION #: AP1229681
DATE PAID:
FEE PAID•
RECEIPT #:
DOCUMENT #: PR1010662
osTDs #:00-0750-N
[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 [
1,350 ]
GALLONS / GPD Septic
CAPACITY
A [
]
GALLONS / GPD
CAPACITY
N [
]
GALLONS GREASE INTERCEPTOR CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [
]
GALLONS DOSING TANK CAPACITY [
]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
D [
975 ]
SQUARE FEET
SYSTEM
R [
]
SQUARE FEET
SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED
[ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [X] BED [
N
F LOCATION OF BENCHMARK: BM paint corner Of transformer
I ELEVATION OF PROPOSED SYSTEM SITE [ 17.0011[
E BOTTOM OF DRAINFIELD TO BE [ 47.0011[
FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
BENCHMARK/REFERENCE POINT
FT ] [ ABOVE FBjL0W
L ],
D FILL REQUIRED: [ 0.00 ] INCHES EXCAVATION REQUIRED: [ 45.00 ] IkNCHES
0
T
H
E
R
licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
s. 64E-6.013(3)(0, FAC.
am sized for a maximum of 75 seats.
icant must obtain an annual industrial and manufacturing operating permit before final approval will be given.
SPECIFICATIONS BY: Brian J Ingram TITLE: Environmental Specialist I
APPROVED BY: , TITLE• Environmental Specialist I
6sian .T 1 am Ah
DATE ISSUED: 03/24/201
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
MG0
Incorporated: 64E-6.003, PAC
v 1.1.4 e1P1229661 SE989161
St' Lucie 2HD
Page 1 of 3
SCANNED
BY
STATE OF FLORIDA St. Lucie County
{~` DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
I,] New System [ ] Existing System [ ] Holding Tank
[ ] Repair [ ] Abandonment [ ] Temporary
APPLICANT:
AGENT:
PERMIT NO.
DATE PAID:
FEE PAID:
RECEIPT #: [ r
[ ] Innovative
I ]
TELEPHONE: �12j-f `&-S7/,c-y
MAILING ADDRESS: 16tO S6- CH,k- I i/_ U170i
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. G GSA SUBDIVISION:
PROPERTY ID #:
PLATTED:
ZONING: I/M OR EQUIVALENT: [ Y/® ]
PROPERTY SIZE: 1.4.q ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [X]<=2000GPD [ ]>20000PD
IS. SEWER AVAILABLE PER 381.0065,
FS? [ Y/O] ]
DISTANCE TO SEWER: FT
B�IAS
PROPERTY ADDRESS: /-(?00
DIRECTIONS TO PROPERTY:
p
/,A'.
Combo
1230
BUILDING INFORMATION
Unit Type of
NO Establishment
I ( �[r✓ -ALA }iov�
2
3
4
[ ] Floor/Equipment Drains
f-Y{H�t;4Y4:ANi
[ ] RESIDENTIAL [)(I COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sq£t Table 1, Chapter 64E-6, FAC
3rxc�pITKn i-a
[ ] Other (Specify) Ni1-
DATE: .3 -14-) Li
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICATION # AP1229681
PERMIT # 56-SF-02480
DOCUMENT # SE989161
- APPLICANT: William Aldridge SCANNED
CONTRACTOR / AGENT: William Aldridge R)
LOT: 1-27 BLOCK: 64 &65 St. Lucie County
SUBDIVISION: ID#: 1428-702-1501-000-1
TO BE COMPLETED HY 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: 4.74 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 585 GALLONS PER DAY [ - RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 11849.98 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1500.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1462.60 SQFT
BENCHMARK/REFERENCE POINT LOCATION: BM p6
ELEVATION OF PROPOSED SYSTEM SITE 17.00
of transformer
/ FT ] [ ABOVE /IBELOWI] BENCHMARK/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: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT
BUILDING FOUNDATIONS: FT PROPERTY LINES: 5 FT POTABLE WATER LINES: _ FT
SITE SUBJECT TO FREQUENT FLOODING?
10 YEAR FLOOD ELEVATION FOR SITE:
SnTT. ARr1FTT.F. TNFORMATION SITE 1
[ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [XIN03
FT [ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
USDA SOIL SERIES:Pendarvis sand
Munsell#/Color Texture
Depth
1 OYR 412
Fill - Sand
0 To 14
1 OYR 211
Loamy Sand
14 To 27
10YR 4/1
Sand
27 To 31
1 OYR 6/1
Sand
31 To 38
10YR 212
Spodic Material
38 To 45
10YR 313
Sand
45 To 57
7.5YR 4/6
CMN/PRM RF
54 To 57
10YR 2/2
Loamy Sand
57 To 72
nrT_ RDnCTT.0 TNRnRMLTTr1N CTTF. i
USDA SOIL SERIES:Pendarvis sand
Munsell #/Color Texture
Depth
10YR412
Fill - Sand
0To 14
10YR 2/1
Loamy Sand
14 To 27
1 OYR 4/1
Sand
27 To 31
10YR 6/1
Sand
31 To 38
1 OYR 212
Spodic Material
38 To 45
1 OYR 3/3
Sand
45 To 57
7.5YR 4/6
CMNIPRM RF
54 To 57
1 OYR 212
Loamy Sand
57 To 72
OBSERVED WATER TABLE: 65.00
INCHES [ ABOVE / ELOW ]
EXISTING GRADE
TYPE:
[ PERCHED /
APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 54 INCHES [ ABOVE
/
BELOW ]
EXISTING GRADE
HIGH WATER TABLE VEGETATION:
[ ]YES [X ]NO
MOTTLING: [X]YES
[ ]NO
DEPTH: 54.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.60 DEPTH OF EXCAVATION:
DRAINFIELD CONFIGURATION: [ ] TRENCH [X ] BED [ ] OTHER (SPECIFY)
IREMARKS/ADDITIONAL CRITERIA
WSWT determined using USDA VISE and soil borings.
Common prominent redox features 7.5YR416 mottles in 10YR3I3 matrix @ 54" In both borings.
SB 1 and SB 217" below BM
SITE EVALUATED BY:
(ngram�rjan (Title: Environmental Specialist l) (ENVIRUNMEN IAL HtALIR)
DR 4015, 08/09 (Obsolete. previous edit ns which may not be used) Incorporated: 64E-6.001, PAC
AP1229681 EID344269
45 INCHES
DATE: 03/16/2016
Page 3 of 4
V 1.0.2
I RECEIVED API; 2 6 2036 PERMIT #: 56-SF-02480
STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION #: AP1229681
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM FEE PAID:
CONSTRUCTION PERMIT
SCANNED RECEIPT #:
BY DOCUMENT #: PR1010662
St. Lucie County osms #: 00-0750-N
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: William Aldridge
PROPERTY ADDRESS: 2900 Industrial 33rd St Fort Pierce, FL 34946
LOT: 1-27 BLOCK: 64 &65 SUBDIVISION:
PROPERTY ID #: 14Z6-7OZ-1S01-000-1 [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 [
1.350 ]
GALLONS / GPD Septic
CAPACITY
A [
]
GALLONS / GPD
CAPACITY
N [
]
GALLONS GREASE INTERCEPTOR CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [
]
GALLONS DOSING TANK CAPACITY [
]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
D [
975 ]
SQUARE FEET
SYSTEM
R [
]
SQUARE FEET
SYSTEM
A TYPE
SYSTEM:
[x] STANDARD [ ] FILLED
[ ] MOUND. [ ]
I CONFIGURATION: [ ] TRENCH [x] BED [
N
F LOCATION OF BENCHMARK: BM paint corner of transformer
I ELEVATION OF PROPOSED SYSTEM SITE [ 17.001[ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 47.00If INCHES FT ][ABOVE BE{{LOW BENCHMARK/REFERENCE POINT
L i
D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 45.001 'INCHES
0
T
H
E
R
The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
With s. 64E-6.013(3)(0, FAC.
System sized for a maximum of 75 seats.
Applicant must obtain an annual industrial and manufacturing operating permit before final approval will be given.
I(*!j SPECIFICATIONS BY: Brian J Ingram TITLE: Environmental Specialist I
{
APPROVED BY: TITLE: Environmental Specialist
Arian J I mn
DATE ISSUED: 03/24/201 E
DH 4016, 08109 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
v 1.1.4 181229661 SE969161
CHD
Page 1 of 3
,11 /&6a-CS4�Q3
=.a Q STATE OF FLORIDA
i - DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
�t CONSTRUCTION INSPECTION AND FINAL APPROVAL.
•A<oo aeiT" .
APPLICATION #:AP1229681
PERMIT #:56-SF-02480
.DOCUMENT #:FI1087649
DATE PAID:03/14/2016
FEE PAID:515.00
RECEIPT #:56-PID-2903625
APPLICANT: William Aldridge
AGENT: William Aldridge
PROPERTY ADDRESS: 2900 Industrial 33rd St FortPierce, FL34946
LOT: 1-27 BLOCK: 64 &65
SUBDIVISION: ID#: 1420-702-1501-000-1
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
C 1
[ I
TANK INSTALLATION
[011 TANK SIZE [1] 1650.00 [21
[021 TANK MATERIAL Concrete
[031 OUTLET DEVICE
[041 MULTI -CHAMBERED ELYj N ]
[051 OUTLET FILTER PolylokA1800
[061 LEGEND 1. 01-011-29DC4 2.
1073 WATERTIGHT
[081 LEVEL
[091 DEPTH TO LID
DRAINFIELD INSTALLATION
[101 AREA [1] 990 [21 SOFT
[111 DISTRIBUTION BOX HEADER Y.
1121 NUMBER OF DRAINLINES 1. 6.00 2.
[131 DRAINLENE SEPARATION
[141 DRAINLINE SLOPE
[151 DEPTH OF COVER
[161 ELEVATION [ ABOVE / BELOW ]BM 42.00
[171 SYSTEM LOCATION
[18] DOSING PUMPS
[191 AGGREGATE SIZE
(201 AGGREGATE EXCESSIVE FINES
[211 AGGREGATEDEPTH
FILL / EXCAVATION MATERIAL
[ ] [22]; FILL AMOUNT
[ ] [23] FILL TEXTURE
[ ] [241 EXCAVATION DEPTH
[ ] 1251 AREA REPLACED
[ ] C261 REPLACEMENT MATERIAL
Comments: Comments are on page 2.
CONSTRUCTION I APPROVED / DISAPPROVED 1:
FINAL SYSTEM L AppAOVED / DISAPPROVED ]:
(Explanation of Violations on following page)
SETBACKS
[271 SURFACE WATER
[281 DITCHES
[291 PRIVATE WELLS
[301 PUBLIC WELLS
[311 IRRIGATION WELLS
[321 POTABLE WATER
[331 BUILDING FOUNDATIONS
[341 PROPERTY LINES
[351 OTHER
FILLED / MOUND SYSTEM
[361 DRAINFIELD COVER
[371 SHOULDERS
[381 SLOPES
(39] STABILIZATION
FT
FT
FT
FT
FT
FT
10
FT
9
FT
FT
ADDITIONAL INFORMATION
[ ]
[401
UNOBSTRUCTED AREA
[ ]
[411
STORMWATER RUNOFF
L 1
[421
ALARMS
[ )
[431
MAINTENANCE AGREEMENT
I 1
[441
BUILDING AREA
[ ]
[451
LOCATION CONFORMS WITH SITE PLAN
[ 1
[461
FINAL SITE GRADING
[ 1
[471
CONTRACTOR
[ ]
[481
OTHER INFILTRATOR ARC 24
ABANDONMENT
[ ]
149]
TANK PUMPED
[ ]
[501
TANK CRUSHED 6 FILLED
St. Luce CHD DATE: 08/01/2016
St.
DH 40160 OB/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
EH Database v 1.0.1 AP1229601 . EID343269
CHO DATE: 12/15/2016
Page 2 of 3
i
APPLICATION #:AP1229681
4° STATE OF FLORIDA PERMIT #:56-SF-02480
DEPARTMENT OF HEALTH DOCUMENT #:FI1087649
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DATE PAID:03/14/2016
CONSTRUCTION INSPECTION AND FINAL APPROVAL,
•h�°4 - FEE PAID:515.00
RECEIPT #:56-PID-2903625
Violation Number Comment
Comments
No violations, system ok to cover. Contractor notified onsite.
6x11 long ARC 24 chambers. New 1550 ST.
Waifing for plumbing license before final approval.
NEEDS IM PERMIT BEFORE FINAL APPROVAL
IM permit applied for and given. William T Aldridge. Aldridge and sons Plumbing Contractor Inc. certified plumbing contractor.
Final system approved. Building department emailed final approval.
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database v1.0.1 AP1229681 E10644269