Instructions for Form DH4015 "Application for Construction Permit - Site Plan" - Florida

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4015 PG 2:SITE PLAN INSTRUCTIONS – 64E-6.004, FAC
FOR NEW/EXISTING/MODIFICATION SYSTEM APPLICATIONS: The site plan shall be DRAWN TO SCALE and shall
be for the property where the system is to be installed.
1. The site plan shall SHOW BOUNDARIES WITH DIMENSIONS and any of the following FEATURES THAT EXIST OR
THAT ARE PROPOSED:
 a. Structures;
 b. Swimming pools;
 c. Recorded easements;
 d. Onsite sewage treatment and disposal system components;
 e. Slope of the property;
 f. Wells;
 g. Potable and non-potable water lines and valves;
 h. Drainage features;
 i. Filled areas;
 j. Excavated areas for onsite sewage systems;
 k. Obstructed areas;
 l. Surface water bodies Requires a surveyor to set the Mean High Water Line boundary for tidally influenced surface
water bodies. Requires a surveyor or department staff to set the Mean Annual Flood Line for permanent non-tidal surface
water bodies.
 m. Location of the reference point for system elevation.
 2. If the county health department is responsible for performing the site evaluation, the applicant or applicant’s
authorized representative shall indicate the approximate location of wells, onsite sewage treatment and disposal
systems, surface water bodies and other pertinent facilities or features on contiguous or adjacent property. If the
features are within 75 feet of the applicant lot, the estimated distance to the feature must be shown but need not
be drawn to scale.
 3. If the county health department will not be performing the site evaluation, the applicant or authorized agent shall be
responsible for the measurements to all features, including the pertinent features within 75 feet of the applicant lot. The
location of any public drinking water well, as defined in paragraph 64E-6.002(44)(b), F.A.C., within 200 feet of the
applicant’s lot shall also be shown, with the distance indicated from the system to the well.
 4. If an individual lot is five acres or greater, the applicant may draw a minimum one acre parcel to scale showing all
required features, or the minimum size drawing necessary to properly exhibit all required features, whichever is larger.
The applicant must also show the location of that one acre or larger parcel inside the total site ownership. To scale parcel
must be large enough to provide sufficient authorized flow.
 5. All information that is necessary to determine the total sewage flow and proper setbacks on the site ownership shall
be submitted with the application. The applicant lot shall be clearly identified. A copy of the legal description or survey
must accompany the application for confirmation of property dimensions only.
FOR REPAIR APPLICATIONS: A site plan (NOT REQUIRED TO BE DRAWN TO SCALE) showing:
 property dimensions
 the existing and proposed system configuration and location on the property
 the building location
 potable and non-potable water lines, within the existing and proposed drainfield repair area
 the general slope of the property
 property lines and easements
 any obstructed areas
 any private well show private potable wells if within 100 feet of system, non-potable within 75 feet
 any public wells show if within 200 feet of system
 any surface water bodies and stormwater systems show if within 100 feet of system. Requires a surveyor to set the
Mean High Water Line boundary for tidally influenced surface water bodies. Requires a surveyor or department staff to
set the Mean Annual Flood Line for permanent non-tidal surface water bodies.
 The existing drainfield type shall be described. For ex., mineral aggregate, non-mineral aggregate, chambers, or other.
 Any unusual site conditions which may influence the system design or function such as sloping property,
drainage structures such as roof drains or curtain drains, and any obstructions such as patios, decks, swimming pools or
parking areas.
FOR ALL SITE PLANS (IF APPLICABLE)
 A Coastal Construction Control Line Permit or an exemption notice from the Department of Environmental Protection if
any component of the onsite sewage treatment and disposal system or the shoulders or slopes of the system mound will
be seaward of the Coastal Construction Control Line, established under Section 161.053, F.S. Should the location of the
proposed onsite system relative to the control line not be able to be definitively determined based on the site plan and the
online products available on the DEP website, the applicant shall provide a survey prepared by a certified professional
surveyor and mapper showing the location of the control line on the subject property.
 All plans and forms submitted by a licensed engineer shall be dated, signed and sealed.
 The evaluator shall document the locations of all soil profiles on the site plan.
4015 PG 2:SITE PLAN INSTRUCTIONS – 64E-6.004, FAC
FOR NEW/EXISTING/MODIFICATION SYSTEM APPLICATIONS: The site plan shall be DRAWN TO SCALE and shall
be for the property where the system is to be installed.
1. The site plan shall SHOW BOUNDARIES WITH DIMENSIONS and any of the following FEATURES THAT EXIST OR
THAT ARE PROPOSED:
 a. Structures;
 b. Swimming pools;
 c. Recorded easements;
 d. Onsite sewage treatment and disposal system components;
 e. Slope of the property;
 f. Wells;
 g. Potable and non-potable water lines and valves;
 h. Drainage features;
 i. Filled areas;
 j. Excavated areas for onsite sewage systems;
 k. Obstructed areas;
 l. Surface water bodies Requires a surveyor to set the Mean High Water Line boundary for tidally influenced surface
water bodies. Requires a surveyor or department staff to set the Mean Annual Flood Line for permanent non-tidal surface
water bodies.
 m. Location of the reference point for system elevation.
 2. If the county health department is responsible for performing the site evaluation, the applicant or applicant’s
authorized representative shall indicate the approximate location of wells, onsite sewage treatment and disposal
systems, surface water bodies and other pertinent facilities or features on contiguous or adjacent property. If the
features are within 75 feet of the applicant lot, the estimated distance to the feature must be shown but need not
be drawn to scale.
 3. If the county health department will not be performing the site evaluation, the applicant or authorized agent shall be
responsible for the measurements to all features, including the pertinent features within 75 feet of the applicant lot. The
location of any public drinking water well, as defined in paragraph 64E-6.002(44)(b), F.A.C., within 200 feet of the
applicant’s lot shall also be shown, with the distance indicated from the system to the well.
 4. If an individual lot is five acres or greater, the applicant may draw a minimum one acre parcel to scale showing all
required features, or the minimum size drawing necessary to properly exhibit all required features, whichever is larger.
The applicant must also show the location of that one acre or larger parcel inside the total site ownership. To scale parcel
must be large enough to provide sufficient authorized flow.
 5. All information that is necessary to determine the total sewage flow and proper setbacks on the site ownership shall
be submitted with the application. The applicant lot shall be clearly identified. A copy of the legal description or survey
must accompany the application for confirmation of property dimensions only.
FOR REPAIR APPLICATIONS: A site plan (NOT REQUIRED TO BE DRAWN TO SCALE) showing:
 property dimensions
 the existing and proposed system configuration and location on the property
 the building location
 potable and non-potable water lines, within the existing and proposed drainfield repair area
 the general slope of the property
 property lines and easements
 any obstructed areas
 any private well show private potable wells if within 100 feet of system, non-potable within 75 feet
 any public wells show if within 200 feet of system
 any surface water bodies and stormwater systems show if within 100 feet of system. Requires a surveyor to set the
Mean High Water Line boundary for tidally influenced surface water bodies. Requires a surveyor or department staff to
set the Mean Annual Flood Line for permanent non-tidal surface water bodies.
 The existing drainfield type shall be described. For ex., mineral aggregate, non-mineral aggregate, chambers, or other.
 Any unusual site conditions which may influence the system design or function such as sloping property,
drainage structures such as roof drains or curtain drains, and any obstructions such as patios, decks, swimming pools or
parking areas.
FOR ALL SITE PLANS (IF APPLICABLE)
 A Coastal Construction Control Line Permit or an exemption notice from the Department of Environmental Protection if
any component of the onsite sewage treatment and disposal system or the shoulders or slopes of the system mound will
be seaward of the Coastal Construction Control Line, established under Section 161.053, F.S. Should the location of the
proposed onsite system relative to the control line not be able to be definitively determined based on the site plan and the
online products available on the DEP website, the applicant shall provide a survey prepared by a certified professional
surveyor and mapper showing the location of the control line on the subject property.
 All plans and forms submitted by a licensed engineer shall be dated, signed and sealed.
 The evaluator shall document the locations of all soil profiles on the site plan.
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