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<br />8-1 4 -I ~J953 :\ OPH <br /> <br />F~:Ot1 BOLLEr"JBACK E;UILDE~5 813 855 3475 <br /> <br />P.4 <br /> <br />p~sco ~COUHTY ~HEALTH UH 904 521 4185 <br />AU~-14-95 MOH 10:5~ AM ~ <br /> <br />p.~ 03 <br /> <br />4 <br />..I <br /> <br />STATE OF ~tORID~ <br />DEPARTMENT or kEA~TH AND REH^SILITATIVE SERVICES <br />ONSI~E SEWAGE DISPOSAL S~STBH <br />CONSTRUCTION PE~IT <br />Au~he~ity; Chapter 381, FS & Chaptftr 100-6, FAC <br /> <br />PERMIT I <br />OA'tr; PAID <br />FEE PAlO $ <br />f{tC!:IPT , <br />StrQee Name <br /> <br />9S-649S-t.AS'I' <br />t _ <br />OS/01/fJS <br />18!'J.OO <br />7189 <br />COPELAND <br /> <br />CONSTR~CTIO~ PERMIT FORt <br />{Xl Nww Syet~m (} Exiatinq SY8~em <br />I J Rgpair C } Abandonment <br /> <br />Holding Tank <br />Other (Specify ) <br /> <br />( J Tempol:'ary,llxp4!trimental srBt.eltl <br /> <br />APPLICANT; JEFP M.ATTOX <br /> <br />AGENT: DOUG L~~S <br /> <br />PROP~RTY STREET ADDRESS: WHSE COPELAND DR <br /> <br />ZSl'lf~RHILLS <br /> <br />LOT: 0 <br /> <br />SLocl<.: lOO <br /> <br />SUBDIVISION: METES & BOUNDS <br /> <br />PROPERTY IO #; 24-26-21-0000-00100-0000 <br /> <br />IS~CTION/TOWNSHIP!RA~GE/PARCEL NO.) <br />{OR TAX 10 NUMBER] <br /> <br />.S~~----~~~~-~----===~~~~~~~=~~o~~.a_..&a..~=a..se,~~~.e~~~=~=_~_e~~====~_g.~a~~~=~__~..~_~~.a~~~ <br /> <br />SYSTeM MUST B~ CONSTRUCTED IN ACCORDANCE ~ITH SPECIFICATIONS AND STANDARDS OF CHAPTER 100-6, FAC <br />REPAIR PERMITS AND HOLD1NC TANK PERMITS ~XPIR~ 90 OAYS F~O~ THE O~T~ OF ISSUE. ALL OTHER PERMITS <br />E~tI~ is HON~HS FROM THE DATE OF IS~UE, M~S AFPROVAL OF SYSTEM OO~S NOT GUARANTEE SATISr~CTORY <br />Pt~FORHANCE FOR AN~ SPEClrlC PERIOD OF TIME. ANY CHANGE IN KAT~RIAL FACTS WHIcH ~ERVED AS A <br />BAsIs FOR ISSUANCE OF THIS PERM1T. REQUIRE THE APPLICANT TO MODIfY THS PERMIT A~P~ICATION. SUCH <br />MODIFICATIONS MAY RESULT 1M THIS i'~RMIT El!,;ING MADE t<ULL 1\.ND VOID. <br /> <br />ED~~;~~a~~~=_~I==~=~~.a~=~;~%~~=,;~~~==~~~&~*_....~~~~_~__~m~====_.~~o=.~......ca~~~~~;_~__~~~~= <br /> <br />SYSTtM DESIGN AND SPECIFICATIONS <br /> <br />T <br />A <br />N <br />K <br /> <br />900 <br />o <br />o <br />o <br /> <br />C GALLONS ) SgPTIC TANK <br />(GALWNS I (;~Dl <br />GALLONS GREAS~ INTERCEPTOR CAPACITY <br />GALLONS PER DOSE <br /> <br />MULTI-CHAMBS~O/IH SERISS:[Yj <br />C~PACITY MVLTI6CHAMBERED!IN SERIES:(Y) <br />[MAXIMUM CAPACITY SINGL~ TANK: 1250 GALLONSj <br />DOSE RATE (01 ?ER 24 HRS NO. OF PUMPS; {OJ <br /> <br />D <br />R <br />A <br />1 <br />N <br />f' <br />I <br />E <br />L <br />D <br /> <br />301 SQUARE fEET PRIMARY <br />t 0 J SQUARE FEET <br />TfPE SYSTEM; <br />COHFIGTJMTION; <br /> <br />STANDARD <br />TRENCH <br /> <br />DRA!NFI~LD SYS~~K <br />S:iSTEM <br />(X ] FILLED <br />(X 1 BED <br /> <br />MOUNt) <br /> <br />LOCATION OF BENCHMARK: ORIG:NAL GRADE IS THE CROWN O~ COPE~ANO RD. <br />EL~VATION OF PROPOSEO SYSTEM SITE IS I 0.0 ) INCHES BE~CP~K/REF&~!NCE POINT <br />50TTOM OF DRAINFIELO TO BE ( &.0 1 INCHES BELOW BE~C~ARX/~EEERENCg POINT <br /> <br />FILL REQUIRED; (lS.Q ) INCH~S <br /> <br />EXCAVA~ION RtQVIRED: ( 0.0 J INCHES <br /> <br />o <br />T <br />H <br />E <br />R <br /> <br /> <br />O~dt3 City of(i~e at (904) 521-4229 when ready for i~~pqctic,n. <br />3 options - Single CDmp~rtment tank with apP~ovQd outlet filter, Multi-cham. <br />fo~ the well wh1eh ~upplie~ drinkino water ~o thi8 site. <br /> <br />. 1"t_ <br /> <br /> <br />SPEiC.IFlCA"l'.IONS <br /> <br />'-l (:.... e - <br />TITLE: e:::.-1 ~/J.?,yrM~J~ 5;Pe c.J~Jt <br />_ TLP;6~u;">>7 .~c<'~. PASCO, Cl'HU <br />EXPIRATION 'DA1:E;O2.. (1Y I if? <br /> <br />APPROV~D B <br /> <br />DATE IssrJEbJ&l/ll{/ ~F <br /> <br />HRS-H Form 4016 March 1992 {ObsoletQs Previous ~dittons Which M~r Not Be Ueed) <br /> <br />4pp!~t <br /> <br />Page 1 ot' 2 <br />