RC-13-2371 PERMIT #: 13-SC-1517576
APPLICATION #:AP1133572
STATE OF FLORIDA
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT RECEIPT #:
DOCUMENT #: PR929169
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CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Raymond Mateo
PROPERTY ADDRESS: 900 NE 100 St Miami, FL 33138
LOT: 1012 BLOCK: 170 SUBDIVISION:
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 11-3206 034-0220 [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 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 [ 867 ] SQUARE FEET bed configuration drainfiel SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
�I CONFIGURATION: [ ] TRENCH [x] BED [ ]
N
F LOCATION OF BENCHMARK: Crown of rd., NE 9 ave., 8.58' NGVD
yI ELEVATION OF PROPOSED SYSTEM SITE [ 32.40 ] [ INCHES FT ] [ ABOVE BELOW]BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 2.40 ] [ INCHES FT ] [ ABOVE BELOW]BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 72.00 ] INCHES
Invert elevation of drainfield to be no less than 9.28' NGVD.
O *Bottom of drainfield elevation to be no less than 8.78.00' NGVD.
T *Install 42"of slightly limited soil under the bottom of drainfield.
H -Perimeter of excavation area shall be at least 2 ft.wider and longer than the proposed absorption bed or drain trench.
The system is sized for 5 bedrooms with a maximum occupancy of 10 persons(2 per bedroom),for a total estimated flow
E of 520 gpd.
The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with
R
SPECIFICATIONS BY: Charle "/ Chapman TITLE: Master Septic Tank Contractor
APPROVED BY: {/ TITLE: Dade CHD
= arlos M aza
DATE ISSUED: 02 4 EXPIRATION DATE: 08/07/2015
{ DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
♦„ Incorporated: 64E-6.003, FAC Page 1 of 3
:R3.a _ "AP1133572 SE919109
i
STATE OF FLORIDA APPLICATION # AP1133572
DEPARTMENT OF HEALTH PERMIT # 13-SC-1517576
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE919109
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Raymond Mateo
CONTRACTOR / AGENT: Chapman Septic
LOT: 1012 BLOCK: 170
SUBDIVISION: ID#: 11-3206-034-0220
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: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.42 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 520 GALLONS PER DAY [RESIDENCES-TABLET / OTHER-TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 1049.99 GALLONS PER DAY [ 1500 GPD/ACRE OR 1 2500 GPD/ACRE ]
-UNOBSTRUCTED AREA AVAILABLE: 1300.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1300.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Crown Of rd., NE 9 ave., 8.58'NGVD
ELEVATION OF PROPOSED SYSTEM SITE 32.40 [FINCHES-]/ FT ] [ ABOVE / BELOW ] 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 [ ]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON-POTABLE: FT
BUILDING FOUNDATIONS: 10 FT PROPERTY LINES: 15 FT POTABLE WATER LINES: 100 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: 11.20 FT [ MSL / NGVD
SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2
USDA SOIL SERIES: Urban land USDA SOIL SERIES: Urban land
Munsell#/Color Texture Depth Munsell#/Color Texture Depth
1OYR 4/1 Sand 0 To 30 10YR 4/1 Sand 0 To 30
10YR 5/6 Oolitic Limestone 30 To 72 10YR 5/6 Oolitic Limestone 30 To 72
OBSERVED WATER TABLE: INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 99 INCHES [ ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Replacement 4-FS/0.60 DEPTH OF EXCAVATION: 72 INCHES
DRAINFIELD CONFIGURATION: [ ] TRENCH [X1 BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA
*SITE EVALUATED BY: DATE: 01/27/2014
a Chapman,Charles(Title:Master Septic Tank Contractor)(Chapman Septic Service,Inc.)
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4
AP1133572 ElD1517576 v 1.0.2
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#A02, Tallahassee, Florida 32399-1703. The
Agency Clerk's facsimile number is 850-410-1448.
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. i
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