Laserfiche WebLink
<br />136/14/2004 134:11 3525236913 PASCO CHD PAGE 01 <br />. STATE OF FLORIDA CENTRAX it: 51-88-15078 <br />DEPARTMENT OF HEALTH DATE PAID; <br />ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID $ <br />COJl'STRV'CTION PBRMJ:'r RECEIPT <br /> OSTDSNBR 04,,1320- -A <br /> <br /> <br />CONSTRUCTION PERMIT FOR: <br />{ } New System ( ]Existing System <br />[ ] Repair [ X ]Abandonment <br /> <br />) Holding Tank <br />] Temporary <br /> <br />] Innovative Other <br />} Modification <br /> <br />APPLICANT: patel. Kebul <br /> <br />AGENT: 156461, <br /> <br />PROPERTY STREET ADDRESS: 6239 Bort Eing ad Zephyrhil18 BL 33541 <br /> <br />LOT: 'M&B BLOCK: SUBDIVISION: Zephyxohi11s Colony C <br />[Section!Township!Range/parcel No.] <br />PROPERTY 10 I: 03~6210010096000010 [OR TAX ID NUMBER) <br /> <br />SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E-6, PAC <br />DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME <br />PERIOD. ANY CHANGB IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, <br />RBQUIRE THE APPLICANT TO MODIFY THE PBRMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS <br />PERMIT BEING MADE NULlo AND VOID. ISSUANCE OF THIS PERMIT DOES NOT BXEMPT THE APPLICANT FROM <br />COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMI'l"1'ING REQUIRED FOR PROPERTY DEVELOPMENT. <br /> <br />SYSTEM DESIGN AND SPECIFICATIONS <br /> <br />r [ <br />1\ ( <br />tif [ <br />K [ <br /> <br />o <br />o <br />o <br />o <br /> <br />) Gallons SEPTIC TAIi1X <br />] Gallons <br />] GALLONS GREASE INTERCEPTOR CAPACITY <br />] GALLONS DOSING TANK CAPACITY [ 0 <br /> <br />MULTI-CHAMBERED/IN SERIES: [Y <br />MULTI-CHAMBERED/IN SERIES: [Y <br /> <br />J GALLONS li [0 ] DOSES PBR 24 fIRS # PUMPS [ 0 <br /> <br />J 0] SQUARE FEET PRIMARY DRAINFIELD SYSTEM <br />R [ 0 I SQUARE FEET SYSTEM <br />~ TYPE SYSTEM: [ R } STANDARD [ If ] FILLED <br />[ CONFIGURATION: [ R ] TRENCH [ If 1 BED <br />~ <br />? <br /> <br />.. 1 MOUND (H) <br />.. ] <br /> <br />t <br /> <br />LOCATION TO BENCHMARK: <br />ELEVATION OF PROPOSED SYS1'BM SITE [ <br />BOTTOM OF ORAINFIELD TO BE [ <br /> <br />0.0 <br />0.0 <br /> <br />( !'nT <br />( JrD'l' <br /> <br />J <br />J <br /> <br />Bm.ow I BENCHMARK/REFERENCE POINT <br />J BENCHMARK/REFERENCE POINT <br /> <br />0.0 ] INCHES <br /> <br />;: <br /> <br />) PILL REQUIRED: [ 0.0 ]INCRES <br /> <br />EXCAVATION REQUIRED: <br /> <br />>THER REMARKS: <br />:'be licen..4 contractor inst.alliug the "'8t.am is re.ponsible for installing t;ha ainJ.mum <br />:ategory of tank in accor4aDce with. 8. UIHi. 013 (3) (I). PAC. <br />Pump tank. cruah or rupture bot;~. fill witb 8uitable 80il. provide a copy of the pump out <br />receipt to the 4epartment. Contact 4epart1llent for inllpection. <br /> <br />PPROVED BY: <br /> <br /> <br />TITLE: BH Specialist. IX <br />TITLE : _ SpeciaU.at. xx <br /> <br />Pasco <br /> <br />CHD <br /> <br />ATE ISSUED: 6/10/04 <br /> <br />EXPIRATION DATE: 9/8/04 <br /> <br /><< 4016, 03/97 fOblfoletes previou& edition. which _y not be uaed) <br />ltock l'I'ulIIber: 5744 -001-4016-0) IOlltdll___4016-11 <br /> <br />'P1fr7... 1 ,....1' .., <br />