HomeMy WebLinkAboutProject Information RECEi°:-.D 3 A 12 U17 \i 1-1k-d36I
.frs? APPLICATION #:AP1260059
STATE OF FLORIDA PERMIT ;#:56-SF-1729543
DEPARTMENT OF HEALTH DOCUMENT #:Ff1089843
� ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:1213012016
FEE PAID:65.00
RECEIPT #:56-PID-3163812
APPLICANT: Patricia Black
AGENT: Jamie DiFrancesco(AIL Contractor Services)
PROPERTY ADDRESS: 14300 Orange Ave FortPierce, FL 34945
LOT: BLOCK:
SUBDIVISION: ID#: 2307-133-0005-000-2
CHECKED [X1 ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE-AND MUST BE CORRECTED.
TANK INSTALLATION SETBACKS
[ 1 [01] TANK SIZE [1] [2] [ 1 [27) SURFACE WATER FT
[ l (02] TANX MATERIAL [ ] [28] DITCHES ET
[ ] [031 OUTLET DEVICE [ ] [291 PRIVATE WELLS FT
[ 1 [041 MULTI-CHAMBERED [ Y / N ] [ 1 [30] PUBLIC WELLS FT
[ 1 [051 OUTLET FILTER [ J [311 IRRIGATION WELLS FT
[ 1 [061 LEGEND 1. 2. [ 1 [321 POTABLE WATER FT
E 1 [07] WATERTIGHT [ 1 [33] BUILDING FOUNDATIONS FT
[ ] [081 LEVEL ( 1 [341 PROPERTY LINES FT
[ ] [091 DEPTH TO LID [ 1 (351 OTHER FT
DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM
[ ] [10] AREA [1] [2] SQFT [ 1 [361 DRAINFIELD COVER
[ ] [11] DISTRIBUTION BOX HEADER [ ] (371 SHOULDERS
[ 1 [12] NUMBER OF DRAINLINES 1. 2. [ 1 [381 SLOPES
[ 1 [131 DRAINLINE. SEPARATION [ 1 [39] STABILIZATION
[ ] [14] DRAINLINC SLOPE
[ 1 [151 DEPTH OF COVER ADDITIONAL INFORMATION
[ ] [16] ELEVATION [ ABOVE / BELOL1 ]BM [ 1 [401 UNOBSTRUCTED AREA
[ 1 [171 SYSTEM LOCATION [ 1 [411 STORMWATER RUNOFF
[ 1 [181 DOSING PUMPS [ 1 [421 ALARMS
( 1 (191 AGGREGATE SIZE [ ] [43] MAINTENANCE AGREEMENT
[ 1 [201 AGGREGATE EXCESSIVE FINES [ ] (441 BUILDING AREA
[ 1 [211 AGGREGATE DEPTH [ 1 [45] LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL [ ] [461 FINAL SITE GRADING
r 1 (22] FILL AMOUNT [ 1 [471 CONTRACTOR Jamie DiFrancesco(All Cont
[ 1 [23] FILL TEXTURE E ] [48] OTHER
[ ] [24] EXCAVATION DEPTH ABANDONMENT
[ 1 [251 AREA REPLACED [ ) [491 TANK PUMPED 01/03/2017
[ 1 [26] REPLACEMENT MATERIAL [ 1 [501 TANK CRUSHED & FILLED 01/03/2017
Comments:
CONSTRUCTION [ 'APPROVED / St. Lucie CHD DATE: 01/0312017
DISAPPROVED Environmental
l Specie' II Brian J Ingram(ENVIRONMENTAL HEALTH)
FINAL, SYSTEM I APPROVED / DISAPPROVED ]; �,r""—� SC Lucie CHD DATE: 01/03/2017
nvironmantal pR jst II Brian (ENVIRONMEN-TAI-PUTLTH)
(Explanation of Violations on £ollowingpagel
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database.v 1.0.1 AP1269089 EID1729543
dE APPLICATION #:AP1269080
;* STATE OF FLORIDA PERMIT #:56-SF-1729543
¢ DEPARTMENT OF HEALTH
DOCUMENT 4:F{10$9543
ONSITE SEWAGE TREATMENT AND DISPOSAL 'SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:12/30/2016
-TF PAID:65.00
RECEIPT #:5.6-PID-3163812
Violation Number Comment
DR 4026, 06/09 (Obsoletas all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database a 1.0.1 AP1269089 EID1729543