255 Pine Oak 19459 Pool Hidden Lake Villas6 L
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ou i 1983
P U
For HRS use only
COUNTY)
NAME OF POOL)
PERMIT NUMBER) (DATE)
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
OFFICE OF LICENSURE AND CERTIFICATION
PUBLIC HEALTH ENGINEERING SERVICES
JACKSONVILLE, FLORIDA 32231
I 111111I 111111 nill 111 111
This form is to be property filled out and submitted with plans and specifications. The completed
application form, plans and specifications must be submitted in sextu Plicate (or Was n required by
county health department engineering staff.)
PROVISIONALLY
STATE OF FLORIDA
DEPT. OF HEALTH & REHAB. SERVICES
Ipvl R, 0 D
OCT 2 8 1983 SP-C- &?
CENTRAL OPERATIONS SERVICES
OFFICE OF LICEk-JRE-& CERTIFICATION
PUBLIC HEALTH ENGMWNG SERVICES
STRUCTURAL DESIGN N01 COVERED
Approval Sump and Date
HRS Form 914, Doe 79IRePi— previous edition; obsolete; ESwP-1 & 2)
TO THE DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES:
The Residential Communities of America
Insert title of body making application, i.e.,, municipality, corporation or individual owner)
whose address is 158 E. Altamonte Drive, Altamonte Springs, Florida 32714
Street and Number ) (City) (Zip Code)
authorized by law to act for the said
Insert city, town, corporation or individual)
and to expend its fund for a swimming pool, herewith. submit for the consideration of The Department of Health and Rehabilitative
Services, plans, specifications and other necessary data prepared by
T. N. Davis
Engineer or Firml
of
P. 0. Box 250, Altamonte Springs, Florida 32715
Street and Number) (City or Town) (Zip Code)
who is hereby authorized to represent the applicant in the engineering features including supervision of construction and appropriate
certification as to compliance with the approved plans and specifications of this project for the installation of
New Pool
Clearly describe: new pool or alteration of existing pool)
to serve Hidden Lake Villas Located at Live Oak Blvd.
Name of motel, club, hotel, city, etc.) (Pool Address)
in/near the city of Sanford in the county of Seminole State
of Florida, as required by the regulations of the Department of Health and Rehabilitative Services and herewith make application to The
Department of Health and Rehabilitative Services for approval of this project.
These plans and specifications and related documents will be approved and accepted by the applicant when they have received the approval
of The Department of Health and Rehabilitative Services.
Upon construction, these facilities will be owned by Residential Communities of America
and will be operated and maintained by Residential Communities of America
Owner or other)
wtose address is158 E . Altamonte Drive, Altamonte Springs, Florida 32714 Street
and Number) (City or Town) (Zip Code) This
application is made under and in full accord with the provisions of Chapters 381, and 514, Florida Statutes, and Chapter 1013-5, Swimming Pools
and Bathing Places, Florida Administrative Code. The applicants agree that no changes in or deviation from the plans and specifications approved
by The Department of Health and Rehabilitative Services will be made except with the consent and approval of The Department of Health
and Rehabilitative Services. Further, the applicants and/or owners agree to provide the necessary funds for equipment and chemicals required
for the continued proper operation, maintenance and repair of this public swimming pool. Attached
is a certified check or money order for required fee of $ 100.00 The
design engineer certifies to the preparation of the engineering documents
submitted herewith and agrees to furnish a certificate of construction
and installation upon satisfactory completion of the project
a -
f (- .K 3 Signature:
Engineer registered under Florida Statutes T.
N. Davis, #7857 Typed
name and Florida, registration number Signature:
Owner, Lessee Manager Typed
Name and ills of ab ve ENGINEER'
S SEAL
SWIMMING POOL INFORMATION
Name of Pool Hidden Lake
1. Estimated cost of construction $ 32,000.00 2. Bathing load 24
3. Type of pool: Indoor Outdoor XX
4. Shape -Swimming pool
Rectangular Other pool
A 610" G N/A
A C B 421011 Width 241011
6 -
GC N/A Length 48' 0"
E D 61011 Area 1,152 sa . f t .
E 61611 Perimeter 144' 0"
30" F
5. Volume in gallons —Swimming pool 44 , 506 Other pool
6. Number and height of diving boards or towers N /A
7. Material from which pool walls and floor are constructed Reinforced concrete floor with rPi nforrPd glini tP
wal 1 s Surface finish Marci to
8. Source of water: City of Sanford Approval No. . Date
Water Closets • Urinals Lavatories
9. Number of sanitary facilities:
Pavilion
Maximum distance
10. Location of sanitary facilities from pool (feet) 45'
11. Number and location of showers One deck shower at pool Side
12. Number of hose connections provided One in Vak Pak (Vaccum breakers are required)
13. Number of units served 200 !Estimated population served 450 Number of stories 1-2
14. Describe mathod'of pool water disposal 4" air gap into Storm sewer -
Distance from pool
15. (A) Recirculation pump(s)
Sta-R1 to El .5 X 2 X 6 124 GPM At 60 T.D.H. H.P. 5
Make and Model (Feet)
NOTE: Attach pump manufacturer's curve(s)
p /`/" / /
n /% /
U
B) Filter(s) D. E. Universal 19" Area 62 Sq. Ft.
Type Make Model
16. Disinfection equipment: Make and Model Bio-Lab MA-35
Gaseous Type PPD HypochIorination GPD Other Type
8 .40 PPD
17. Other chemical feeders: Make and Model Rol acl or RC-100' Capacity 36 GPD
Makeand Model Vak Pak DP-75 -Dry Dry Feeder capacity
18. Test Kit: Make and Model Taylor 2005
Test Capabilities FAC TAC Ph CAH TA AND l YA
19. Remarks:
These plans for the proposed construction cited in the foregoing application are hereby approved under authority of Chapters 3B1 and 514, Florida
Statutes, with the following provisos:
1. Construction on tHis project shall be commenced within one year from the date of approval of this application otherwise six (6) months approval
extension shall be obtained from the Department prior to commencing construction.
2. This approval is given with the understanding that upon the installation of such works, its operation shall be placed under the care of a competent
person, whose qualifications are acceptable to The Department of Health and Rehabilitative Services and the operation shall be carried out
according to best accepted practice and in accordance with the rules and recommendations of The Department of Health and Rehabilitative
Services. This includes not only the provision of continuing necessary and essential funds to operate and maintain the chemical supplies and
facilities; but also the funds for equipment and chemical resupply necessary for proper operation of this public swimming pool.
3. Pool water disposal shall be in accordance with local requirements including the obtaining of all necessary permits.
4. Potable water supply serving this pool shall be protected from contamination.
5. Shepherds hook shall be attached to a solid 16 foot pole.
6. This pool appears too small for the number of units being served.
By copy of letter of approval to the owner, we are advising that approval is given functional aspects of this project on the basis of representations
to and data furnished this Department: and there may be county, municipal or other local regulations or restrictions to be complied with by
the owner prior to construction of the facilities represented by the referred to plans; and we, therefore, recommend that appropriate local
agencies be consulted before starting construction.
The official copies of plans and specifications accompanying this application have been sealed and stamped with the serial number as indicated
hereon. Only such plans and specifications are included in this approval and any erasures; additions or alterations affecting the efficiency of operation
or public health protective value of the proposed improvements will make such approval null and void.
OC1 2 8 19a3
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
OFFICE OF LICENSURE & CERTIFICATION
I PUBLIC HEALTH ENGINEERI G SERVICES
STATE OF FLORIDA
DEPT. OF HEALTH & REHAB. SERVICES
Chief-:"
5eFDDOWlBy]
HRS Engineer
SP-C- e- C1J_4;
CENTRAL OPEVATIONS SERVICES
OFFICE OF LICENSURE & CERTIFICATION
PUBLIC HEALTH ENGINEERING SERVICES
STATE OF FLORIDA
DEPARTMENT OF
a Health & Rehabilitative Services
1350ORANGE AVENUE, SUITE 11 1
Mr. T. N. Davis, PE
P. O.:Box 250
Altamonte Springs, FL 32715
Dear Mr. Davis:
Bob Graham, Governor
WINTER PARK, FLORIDA 32789
November 9, 1983
Seminole County
Hidden Lake
Live Oak Boulevard
Sanford', FL
Reference is made to the submitted plans and related documents pertaining to the
proposed construction of a public pool to serve the above captioned location.
Effective 10/28/83 these documents are approved under Serial No. SP-C9429
subject to the following proviso(s): (See below or attached).
1. _Shepherds hook sha;; be attached to a solid 16 foot pole.
2. This pool appears too small for the number of units being served.
Your attention is specifically directed to the requirement of your monitoring
the installation and construction of the pool to insure compliance with these
approved materials since it has been indicated on the application that you have
agreed for this service. We bring this detail to your attention now, inasmuch
as your eventual certificate of construction completion in accord with approved
plans, along with appropriate certification by the contractor and the pool
owner, is necessary for execution of the application for the operating permit
forms. We are herewith enclosing five (5) copies of HRS Form 916, of which four
4) executed copies shall be returned to the undersigned (along with the
required sixty-five ($65.00) fee) upon successful completion of the pool. :By
copy of this letter, the applicant is advised that unauthorized operation and
use of the pool without a valid State operating permit is a violation of Chapter
514, Florida Statutes, and Chapter 10D-5 of the Florida Administrative Code, and
may subject the owner to appropriate legal action.
Approval is given to the functional aspects of this project on the basis of
information and data furnished to this Department. There may be county,
municipal, or other local regulations or restrictions to be complied with by you
prior to construction of. the facilities represented by the plans referred to
above, and we, therefore, recommend that appropriate local agencies be consulted
before starting construction.
Upon receipt of the approved materials referred to herein, one set shall be
forwarded to your client, the applicant, and one set shall be forwarded to the
contractor for keeping on the construction site. Thank you for your
cooperation.
LMC/bah Sincerely,
cc: Mr. R. J. Hammerstrom, PE Loran M. Coffman
cc: Seminole County Regional Engineer
cc: Residential Communities of Public Health Engineering Services
America
158 East Altamonte Drive
Altamonte Springs, FL 32714
BUILDING DEPARTMENT
CITY OF SANFORD
Reference: HIDDEN LAKE SWIMMING POOL
Gentlemen:
Please accept this letter as authorization for,the following person to
obtainthe necessary Building Permit for the above -named project: PERRY
WALKER Very
truly yours, WELLER
POOL CONSTRUCT RS, NC. esident
Weller V
HJV/
lp STATE
OF FLORIDA COUNTY
OF SEMINOLE Subscribed
and sworn to before me this&tAjay of (;QC. to
P"Cb if'c_ LARGE
NOTARYPUBLICSTATEOFEXPIRES
DE FLORIDA
Ma
R 17,A19f33 MYCOMMISSIONBonded
By American Fire And Casualty Company POST
OFFICE BOX 250 • ALTAMONTE SPRINGS, FLORIDA 32701 19Y3
305)
862-7551
I ddeh alee
a 55 P; o,e 0C.",k
perM l 9459