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PLC-18-724 `SHORES L�� Miami Shores Village " 3.,.. �•. �lm�1t�" t7tt1'11YI�ii 10050 N.E.2nd Avenue NE .... tI� . , a, Miami Shores,FL 33138-0000 er Phone: (305)795 2204 Permit Status:'APPR APPROVED FLORIDA � 44, ue Date 4/3/2018 Expiration: 09/30/2018 Project Address Parcel Number Applicant 9475 NE 2 Avenue 1132060133760 BANK OF AMERICA NA Miami Shores, FL 33138- Block Lot: Owner Information Address Phone Cell LBANK OF AMERICA NA 13510 BALLANTYNE CORP Place CHARLOTTE NC 28277- 9475 NE 2 Avenue MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone _••�•_.�••_ .... Valuation: $ 10,000.00 A-1 PARADISE PLUMBING INC (954)563-0110 Total Sq Feet: 0 Type of Work:SEPTIC TANK ABANDONMENT Available Inspections: Type of Piping:SEPTIC TANK ABANDONMENT Inspection Type: Additional Info: Top Out Classification:Commercial Re Pipe Scanning: 1 Main Drain Heater Water Service Final Water Main Lavatory Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $6.00 Invoice# PLC-3-18-66860 DBPR Fee $4.50 DCA Fee $3.00 04/03/2018 Check#:32637 $326.50 $0.00 Education Surcharge $2.00 Permit Fee $300.00 Scanning Fee $3.00 Technology Fee $8.00 Total: $326.50 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL,WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAV : I rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo in Futhermore, I aMorize the above-named contractor to do the work stated. April 03, 2018 Author ed Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy April 03, 2018 1 DIVISION OF OEnvironmental Health Florida Health QQ��� Miami-Dade County OSTDS NVell Division D 11805 SW 26th Street•Miami,FL 33175 Inspector � ' d Date Address 9 OSTDS# Comments: T/ Signature ature Raider Rooter 804 SE 1 st Street a (561)737-8818 Phone Ste A office@ raiderrooter.com Boynton Rearh Ft X3435 www.raiderrooter.corn MQH(' C) U I UC°U� C� Bill To Ship To Paradise Service Technologies Paradise Sery/Bank Of America 260 SW 21 st Ter 9499 NW 2nd Avenue Ft Lauderdale FL 33412 Miami Shores FL 33138 Work Order# 6348 Transaction Date: 04/21/2018 Terms: Due on receipt Invoice 15144 Item Description Quantity Price Amount Pump Septic Pump Septic Tank- Pumped 1500 gallons 1 $355.00 $355.00 Tank Abandon Abandon Septic Tank 1 $175.00 $175.00 Septic Tank 1 Subtotal $530.00 Tax $0.00 Total $530.00 Authorization Acceptance I hereby authorize Raider I hereby accept the service. Payments $0.00 Rooter to complete the repair or replacement as Balance Due $530.00 proposed service, repair, or complete and satisfactory. replacement and agree to pay the invoiced amount upon completion. 1 additionally certify that I am fuliv authorized to authorize this work and commit to payment. ACCOUNT INVOICE ✓ o Quo o Q 'A Pl UGk[ASE PUMPING AND DWN CLEANING SEPTIC TANK&DRAINFIELD INSTALLATION RESIDENTIAL&COMMERCIAL J j7dv�tiftf u� ' d;�e�at�d BOYNTQN BEACH FL 33435 - Ra i de r T Cl?g office@raiderrooter.com www.RaiderRooter.com QATE PHONE NIM SER ARRIVED DEPART CUSTOMER CLASS ' -ResWanhal CUSTOMER NAME E-MAIL Q �Q � 'LComnxrael J�AD01lE CITY ZIP CODE POM t)SC rh vh BILLj4ADdRESS 10 DIFFERENT AUTHORIZED PRICE — Grease Trap Sink Lavatory Sink ®Tubs __ Shower __._ Mud Trap _ Washer ___ Floor Drain Install __ Digging —t'Septic Tank ® Commode ___. Main — Products — Lift Station Draintields r. Waste Jetting ___. Other —Auger _ PM Service SERVICE PERFORMED: l , 1 0 r-\ f. Total $ 1 J Source Cash Check Charge Account Driver License # Credit Card Exp. Date Code WORK ORDER AUTHORIZATION This is tO acknowledge completion of the above described service 4 has been done to my complete satisfaction.I,Purchaser of Services,Agree to Pay 1 hereby authorize you to perform the above described Reasonable Attorney's Fees in the Event that Raider Rooter Has to Hire an Attorney to service and I agree to pay the amounts indicated above. Collect the Amount Due on this invoice.I Hereby Acknoviledee the Receipt of the Rate hereby certify that I am duly authorized to order and Sheet Submitted by Raider Rooter on this Date approve the work requested. Customer Signature Customer Signature Service Technician RC4 d'f Raidez! Miami Shores Village F1� Building Department M � zx g p � 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 BUILDING Master Permit No.71.0 (V" 45 PERMIT APPLICATION Sub Permit No. D.-e tq - --A2-`f [7]BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [7]RENEWAL FM-]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:] CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS :OB ADDRESS: 9499 NE 2nd Avenue City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#:11-3206-013-3760 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: IIB Flood Zone: X BFE: FFE: OWNER:Name(Fee Simple Titleholder):BANK OF AMERICA NA Phone#: Address: 101 N.Tryon Street City: Charlotte State: North Carolina Zip: 28277 Tenant/Lessee Name: Same as Fee Simple Phone#: Email: EIIie.Sanchez@am.jil.com CONTRACTOR:Company Name: A-L PL," ►Oi nq Phone#:35 4- SL !, 011 Address:,Q b ),t T eft(1 c.Q City: 1-a c a&9 rCl r� State: -F-(o bio _ Zip: 2' 1(2, Qualifier Name: � � `� 4, 3 ►(.h Phone#:°) ! y — Slam, - D l/10 State Certification or Registration#: GF(_ O 3S to G1 LQ Certificate of Competency#: Infinity Engineering Group, LLC. 813-434-4770 DESIGNER:Architect/Engineer: Phone#: Address: 1208 E Kennedy Blvd, Suite 230 _City: Tampa State: FL Zip: 33602 Value of Work for this Permit:$ 10 C-5-100 _Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace 0 Demolition Description of Work: Septic Tank Abandonment Specify color of color thru tile: Submittal Fee$ Permit Fee$ 3 �!,? CCF$ CO/CC$ Scanning Fee$ Radon Fee$ 3`0C) DBPR$ - �� Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 32-G' 9y (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs sev 7) days after the building permit is issued. In the absence of such posted notice, the inspection will n e a ro d a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument ,,was �acknowledged befforre� me this The foregoing instrument was acknowledged before me this day of ""°`" �L 20 Vo by day of 1y �G� 20Tit Alan Duryea who ispersonally known to who is personally r, me or who has produced as me or who has produced 00 , C o O n identification and who did take an oath. identification and who did take an oath. Q n NOTARY PUBLIC: NOTARY PUBLIC: Y C- w o U Z $a6lv —k(Zq� Sign: �n �,_/_,�,, Sign: Print: �'Ie vreilir Y'�l.`1 i-cXl Print: e ( +-'fir'. �0 QN 5'(P : ..��e-, r Seal: �; � -__LUCY CUTI�.REiEZ MAATOS Seal: MY COMMISSIGN#FF127876 9 A oFF��• EXPIRES June 1, 2018 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) A�D® CERTIFICATE OF LIABILITY INSURANCE DATE07/05/17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Aon Risk Services,Inc of Florida NAME: Aon Risk Services,Inc of Florida 1001 Brickell Bay Drive,Suite#1100 PHONE Fami,FL 33131-4937 A/C No Ext):800-743-8130INC,AlNo):800-571-7514 EMAIL ADDRESS: ADP.COI.Center Aon.com INSURER(S)AFFORDING COVERAGE NAIL# INSURER A: Illinois National Insurance Co 23817 INSURED INSURER B ADP TotalSource DE IV,Inc. 10200 Sunset Drive INSURER C: Miami.FL 33173 ALTERNATE EMPLOYER INSURER 0: A-1 PARADISE PLUMBING,INC.DBA Paradise Service Technologies INSURER E 260 SW 21st Terrace, Forl Lauderdale,FL 33312 INSURER F: COVERAGES CERTIFICATE NUMBER: 1672005 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMBS LTR INSR WVD MWDD/YYYY MMIDD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S DAMAGCLAIMS-MADE ❑ OCCUR PREMIETORENTED PREMISES Ea occurrence 5 MED EXP An one person) S PERSONAL 8 ADV INJURY $ GEVL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY O PROJECT F7LOC PRODUCTS-COMP/OP AGG S OTHER S AUTOMOBILE LIABILITY (Ea SINGLE LIMIT Ea accident S ANY AUTO BODILY INJURY Perperson) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident S HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident S S UMBRELLA LIAeOCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DEC RETENTION S WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER A ANY PROPRIETORIPARTNER/EXECUTIVE ❑ WC 026160313 FL 7/1/2017 7/1/2018 E.L.EACH ACCIDENT $ 2,000,000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 2,000,000 e yes,descnee under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) All worksite employees working for A-1 PARADISE PLUMBING,INC.DBA PARADISE SERVICE TECHNOLOGIES,paid under ADP TOTALSOURCE,INC.'s payroll,are covered under the above stated policy. A-1 PARADISE PLUMBING,INC.DBA PARADISE SERVICE TECHNOLOGIES is an alternate employer under this policy. CERTIFICATE HOLDER CANCELLATION Miami Shores Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NE 2nd Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores,FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C790/1�i6A i6etviee.6, 4ac of(flotida ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD ACC)RD0 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 6*.� 1 04/19/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Cl T NAME; Tom Rogan Hooper,Hayes and Rogan,inc. 954 47 - FAX PHONE ac.No.E:t1: ( ) 6 5995 I(A/c N.);. 5440 NW 33rd Avenue Ste 110 E-MAIL SS: ANGELB@HHROGANINSURANCE.COM INSURERS AFFORDING COVERAGE NAIC K Fort Lauderdale_ FL 33309 INSURER A: TOKIO MARINE SPECIALTY INSURANCE CO 23854 INSURED INSURER B: COMMERCE AND INDUSTRY INSURANCE CO 19410 A-1 Paradise Plumbing,Inc.,dba INSURER C: Paradise Service Technologies INSURER D: 260 SW 21 Terrace INSURER E Fort Lauderdale FL 33312 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRDU POLICY EFF POLICY EXP ----.-- - ------- LTR TYPE OF INSURANCE I POLICY NUMBER MMIDD ( MM/OD/YYYY LIMITS X COMMERCIAL GENERAL LV181LnY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADEDAMAGETORE I^I OCCUR PREMISES(Ea occurneEU.,e) $ 100.000 _- BI/PD Ded$5000. MED EXP(Any one person) $ 0 A PPK1640811 04/24/2017 04/24/2016 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICYFX]PRO- JECT �F_7j LOC PRODUCTS-COMP/OP AGG s 2,000,000 -- OTHER: $ _._---- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S -_---- -(Eaa clderV0 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LUIS' X OCCUR EACH OCCURRENCE $ 3,000,000 B X Excess LIAB CLAIMS-MADE EBU022712926 04/24/2017 04/24/2016 AGGREGATE $ 3,000,000 DED I RETENTIONS PR/COMP OPS AGG Is 3,000,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YSTATUTE I ER '':ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA A E.L.EACH ACCIDENT S OFFICERWEMBER EXCLUDE09 ---- (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ It yS describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more spaceIs required) PLUMBING CONTRACTOR CFC035696 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Ave AUTHORIZED REPRESENTATIVE Miami Shores A 33138 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD V PERMIT #: 13-SC-1826872 APPLICATION #:AP1331251 STATE OF FLORIDA DEPARTMENT OF HEALTH DATE PAID: + ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: SYSTEM RECEIPT #: DOCUMENT #: PR1096863 CONSTRUCTION PERMIT FOR: OSTDS Abandonment APPLICANT: (Bank of America, National Association) PROPERTY ADDRESS: 9475 NE 2 Ave Miami, FL 33138 LOT: 13-17 BLOCK: 28 SUBDIVISION: Miami Shores Sec 1 Amd [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] PROPERTY ID #: 11-3206-013-3760 [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F,S. , AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL .AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ ] GALLONS / GPD CAPACITY A [ ] GALLONS J GPD CAPACITY N [ ) GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS) K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ )DOSES PER 24 HRS #Pumps [ l D [ ) SQUARE FEET SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ) TRENCH [ ) BED [ ] N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ ] [ i ] [ ABO'" /BELOW I BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ ] [ ! ] [ APOVL,/BEI OWI BENCHMARK/REFERENCE POINT L D FILL REQUIRED: ( 0.00] INCHES EXCAVATION REQUIRED: [ ] INCHES Have the tank abandoned in accordance with the following procedures, (a)The tank shall be pumped out.(b)The bottom of O the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c)The T tank shall be filled with clean sand or other suitable material, and completely covered with soil. Have the system inspected H by the health department after it has been pumped,ruptured and filled with sand and covered. E R SPECIFICATIONS BY: TITLE: APPROVED BY: TITLE: Engineering Specialist II Dade CHD Erlande Omisca DATE ISSUED: 02/28/2018 EXPIRATION DATE: 05/29/2018 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 -. L> NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for administrative hearing must be in writing and must be received by the Agency Clerk for the Department, within twenty-one(21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency Clerk's facsimile number is 850-413-8743. Mediation is not available as an alternative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. Water and Sewer PO Box 330316 • 3071 SW 38 Avenue MIAMI MADE Miami, Florida 33233-0316 T 305-665-7471 VERIFICATION FORM THIS FORM IS NOT VALID WITHOUT A PAID INVOICE AND EXPIRES ONE YEAR FROM THE DATE ON FORM miamidade.gov ATLAS PAGE: F-8 INV* 45513 FORM#: 201869467 DATE: 2/13/2018 NAME OF OWNER: 'BANK OF AMERICA M2018005191 PROPERTY ADDRESS: !9475 NE 2 AVE AKA 9499 NE 2 AVE ...... .. _ .. PROPOSED USAGE/ 'OFFICE BLDG CONNECTING TO SEWER FOR THE IST TIME (PER PAPER PLANS) NO. OF UNITS: _ .. ---- - REPLACES: PREVIOUS OFFICE BLDG(PER CCB#2806618523 AND PTXA FILES USAGE/NO. OF UNITS: __..__._.. ......__._............._._....._-.—._._..�_...__.___ PROPERTY LEGAL: 'MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 13 THRU 17 INC BLK 28 _. _�__... ..._.__........ FOLIO NUMBER: 11-3206-413-3760 GALLONS PER DAY INCREASE 1,007 PROPOSED FLOW: 1,007'. PREVIOUS SQUARE FOOTAGE: 0NEW CONSTRUCTION PREVIOUS FLOW: 0 PROPOSED SQUARE FOOTAGE: 20,140 _j INTERIOR RENOVATION --- CRITICAL HABITAT ADOPTED FLOW: 0 i C SEWER ONLY THIS IS TO CERTIFY THAT THE MIAMI-DADE WATER AND SEWER DEPARTMENT DOES HAVE A(N)J,12_INCH WATER MAIN ABUTTING THE SUBJECT LEGALLY DESCRIBED PROPERTY. WE ARE WILLING TO SERVE THE SUBJECT PROPERTY,(OR, IF"WILL HAVE",UPON PROPER CONVEYANCE AND PLACEMENT INTO SERVICE OF WATER FACILITIES BY THE DEVELOPER UNDER AGREEMENT WITH THE DEPARTMENT,(AGREEMENT ID# 21790) SUBJECT TO PROHIBITIONS OR RESTRICTIONS OF GOVERNMENTAL AGENCIES HAVING JURISDICTION OVER MATTERS OF WATER SUPPLY OR WITHDRAWAL. Barbara S, Reding - New Business I �\',.I BY: I Representative S1GNA URET OF REPRESENTATIVE AUTHORIZED BY ....._..._ _ .._.__ NEW BUSINESS COMMENTS: SWR CC'S$5,639.20 ' 3 i THIS IS TO CERTIFY THAT THE MIAMI-DADE WATER AND SEWER DEPARTMENT WILL HAVE A(N),,,,ef8� INCH GRAVITY SEWER MAIN ABUTTING THE SUBJECT LEGALLY DESCRIBED PROPERTY. WE ARE WILLING TO SERVE THE SUBJECT PROPERTY,(OR,IF'"WILL HAVE", UPON PROPER CONVEYANCE AND PLACEMENT INTO SERVICE OF SEWER SEWER FACILITIES BY THE DEVELOPER UNDER AGREEMENT WITH THE DEPARTMENT, (AGREEMENT ID#21790). SUBJECT TO PROHIBITIONS OR RESTRICTIONS OF GOVERNMENTAL AGENCIES HAVING JURISDICTION OVER MATTERS OF SEWAGE DISPOSAL. FURTHERMORE, APPROVAL OF ALL SEWAGE FLOWS INTO THE DEPARTMENT'S SYSTEM MUST BE OBTAINED FROM D.E.R.M. THE ANTICIPATED DAILY WATER AND/OR SEWAGE FLOW FOR THIS PROJECT WILL BE:ONE THOUSAND SEVEN(1007) GALLONS PER DAY INCREASE. y° Barbara S. Reding- New Business 4 Representative BY: ``�` L SIGNATURE OF REPRESENTATIVE AUTHORIZED BY NEW BUSINESS COMMENTS: R.E.R.SEWER ALLOCATION LETTER DATED:01-12-2018#2018-00170 THIS VERIFICATION LETTER CERTIFIES THE AVAILABILITY OF A WATER AND/OR SEWER MAIN ONLY,AND IT DOES NOT GUARANTEE THE EXISTENCE OF A WATER SERVICE LINE OR OF A SEWER LATERAL WITH SUFFICIENT DEPTH TO SERVE THE PROPERTY. FOR ADDITIONAL INFORMATION CALL 786-268-5360,SHOULD IT BECOME NECESSARY TO INSTALL A SERVICE LINE ANDIOR A SEWER LATERAL WASD REQUIRES THAT THE DEVELOPER RETAINS SERVICES FROM DESIGNERS AND CONTRACTORS WITH SKILL SETS FOR DESIGNING,BUILDING AND CONNECTING TO PUBLIC WATER AND SEWER SYSTEMS. CONTACT NAME: OfnRIS HAINES Printed On:21412018 NB: Barbara S.Reding 7 CONTACT PHONE:` 813 `7, 11:16:02 AM./� PR: AUTHORIZEP_5Yt--'" i Sanitary Sewer Certification of Adequate Capacity Project Summary: Owner's (Name: BANK OF AMERICA NA Owner's Address: EEOS Allocation Number:2018-ALLOCATION-00170 Project: BANK OF AMERICA NA CONNECTING TO SEWER (M2018005191) Proposed Use: 20140 SF FINANCIAL OFFICE CONNECTING TO SEWER. Pump Station 99-1357A Projected NAPOT: 1.30 Proposed Projected NAPOT: 1.30 o wl", a 113203`3 7160 19475 NE 2 AVE 1,007 APP 1.111/2018 PLC-18-45 Total: 1,007 Gtr i Page 2 of 2