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I <br /> A - I e 1416160 <br /> It I.." 4t.r__1 / . 1 <br /> 44-9 <br /> STATE OF FLORIDA PERMIT .1 S E_1 952504 <br /> DEPARTMENT OF HEALTH DOCUMENT #:F1 1288936 <br /> ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM <br /> CONSTRUCTION INSPECTION AND FINAL APPROVAL' DATE PAID:05/28/2019 <br /> FEE PAID*340.00 <br /> RECEIPT #.51-PID-3954012 <br /> APPLICANT: 1glesla Evangelica Intl <br /> AGENT: wilder gullarte <br /> PROPERTY ADDRESS: 39309 6th Ave Zephyrhills, FL 33542 <br /> LOT: 2 BLOCK: 7 <br /> SUBDIVISION- Zephyrhills Colony Company xD#: 122631002SO07000020 <br /> CHECKED EXI ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. <br /> TAM INSTALLATION SETBACKS <br /> 1 3 [oil TANK SIZE Ell (2) 1 (271 SURFACE WATER FT <br /> [ 1 (021 TANK MATERIAL 1 (281 DITCHES FT <br /> C 1 1031 OUTLET DEVICE 3 [291 PRIVATE WELLS FT <br /> 1 1 1041 MULTI-CHAMBERED C Y N I E 1 [301 PUBLIC WELLS FT <br /> C 1 [053 OUTLET FILTER [ 1 1313 IRRIGATION WELLS FT <br /> 1 1 (061 LEGEND 1, 2. 1 3 [321 POTABLE WATER FT <br /> 1 3 t071 WATERTIGHT f 1 (333 BUILDING FOUNDATIONS FT <br /> E 1 [081 LEVEL ( 1 [341 PROPERTY LINES FT <br /> C I [091 DEPTH TO LID E 1 1351 OTHER FT <br /> DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM <br /> f 1 [101 AREA fil [21 SQFT ( 1 1361 DRAINFIELD COVER <br /> [111 DISTRIBUTION BOX HEADER [ 1 [371 SHOULDERS <br /> E 1 1121 NUMBER OF DRAINLINES 1. 2. ( 1 1381 SLOPES <br /> t I r13j DRAINLINE SEPARATION 1 1 (393 STABILIZATION <br /> E 3 [141 DRAINLINE SLOPE <br /> E I L151 DEPTH OF COVER ADDITIONAL INFORMATION <br /> E I E161 ELEVATION [ ABOVE / BELOW IBM 1 (40) UNOBSTRUCTED AREA <br /> C 1 [171 SYSTEM LOCATION 1 [411 S6DiMWILAER. RUNOFF <br /> E I Cie] DOSING PUMPS 1 (423 ALARMS <br /> ( 1 1193 AGGREGATE SIZE t 1 (431 MAINTENANCE AGREEMENT <br /> I t201 AGGREGATE EXCESSIVE FINES E 1 1441 BUILDING AREA <br /> 1 E211 AGGREGATE DEPTH f 1 [451 LOCATION CONFORMS WITH SITE PLAN <br /> FILL / EXCAVATION MATERIAL 1 1 [461 FINAL SITE GRADING <br /> E 1 [221 FILL AMOUNT 1 1 (471 CONTRACTOR <br /> ( 1 (231 FILL TEXTURE ( 1 [483 OTHER <br /> E 3 [241 EXCAVATION DEPTH ABANDONMENT <br /> E 1 1253 AREA REPLACED [ 10/1,E491 TANK PUMPED <br /> 1 1 1261 REPLACEMENT MATERIAL 16A 1501 TAM CRUSHED & FILLED 7/1 <br /> Comments: <br /> CONSTRUCTION CHI) DATE <br /> ,A1_PR_0V__SP DISAPPROVED <br /> FINAL SYSTEM I APPROVED' DISAPPROVED evo CHD DATE: <br /> (Explanation of violations on following page) <br /> DH 4016, 08/09 (Obsoletes all previous editions which may not be used) <br /> Incorporated: 64E-6.003, FAC Page 2 of 3 <br /> R14 nata0ase v 1.0,1 AP1416150 EIDI952504 <br />