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PW-18-3358Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 01/15/2019 Location Address Parcel Number 77 NE 105 ST, Miami Shores, FL 1121360060150 Contacts Permit NO.: PW-11-18-3358 Permit Type: Public Works Work Classification: Public Works Permit Status: Approved Expiration: 05/06/2019 EZEQUIEL ZYLBERBERG Owner JESSICA SCHILLING Applicant 77 NE 105 ST, MIAMI SHORES, FL 33138 77 NE 105 ST, MIAMI SHORES, FL 33138 Mobile:5617032510 SCHILLINGESI@GMAIL.COM Other:9546293012 DRIVEWAYS BY DESIGN INC Contractor RENE VERLAAT Business: 3057767916 Description: PAVER DRIVEWAY Valuation: $ 7,200.00 Inspection Requests: 305-762-4949 Total Sq Feet: 1,000.00 Fees Amount Education Surcharge $1.60 Public Works Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $2.50 Total : $107.10 Building Department Copy Payments Date Paid Amt Paid Total Fees $107.10 Check # 3150 01/15/2019 $107.10 Amount Due: $0.00 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 la drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assum onsibjlity or all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRI PLUMBI;64CHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS regulating, xegoing information is accurate and that all work will be done in compliance with all applicable laws , I authorize the above named contractor to do the work stated. Owner / Applicant / Contractor / Agent Date January 15, 2019 Page 2 of 2 Miami Shores Village Public Works Department (305)795-2210 Public works forms are available from the building department, 10050 NE 2"d Ave., Miami Shores, FL 33138 PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property f Permiit#: 1 o Name of Applicant (if utility see below): C�rjl C� Z�it�itZ 2 f� ef22rt Owner off the following described property: Legal Description: Lot (S Block 26:1Z Subdivision IV Folio #; ti -2-1 6- o& - 01 S© Address: '4-4 && I b' I+rZid' M i`o-M; , I FFL, Z3 1?q UTILITY NAME: Qualifier/Authorized Agent: Address: City: Telephone: State Certification or Registration #: State: ZIP: Email: Certificate of Competency # CONTRACTOR NAME: Driveways by Design, Inc Qualifier/Authorized A ent: Rene Verlaat Address: 222 NE b5th Street City: Miami State: FL ZIP: 3,31.38 Telephone: 305-77 - Email: rene@drivewaysbydesign.com State Certification or Registration #: Certificate of Competency #: E 17 0 0 3 3 6 permission to install (describe work, attach separate page if necessary) in the adjoining right of way: Type of Work: [2 Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: Address: City: Telephone: Registration #: State: Email: ZIP: Value of Work for this Permit: $ 2 0� Square/Lineal Footage of Word( /, C-Qrlo ***** Fees ***** Permit Fee $ 100.00 Nota'ry $ Training/Education $ 0.20 Technology Fee $ 0.80 Scan in Bond $ (if required) Total Fee Now Due $ 1 r i Bonding Company's Name (if applicable): Bonding Company's Address: City: State: ZIP: Application is hereby made to obtain a public works permit to do the work ill the right of way 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, regulation construction in this jurisdiction. I understand that separate permits must be secured for APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accuratle and that all work will be done in compliance with applicable laws regulating construction and specifically construction in the right-of-way. i f "WARNING TO APPLICANT: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO THE RIGHT-OF-WAY. IF YOU IIIITEND 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 public works permit � �ith an estimated value exceeding $2,500, 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 the attachment. Also, a certified copy of the recorded notice of commencement r`nust be posted at the job site for the first inspection which occurs seven (7) days after the public works' permit is issue he absence of such posted notice, the inspection will not be approved and a reinIspecti11 be harge Signature Signature Applicant or Authorized t Company'/Utility Agent The foregoing instrur Mp this AU day of Sign: Print: SEAL: me or who H4s produced as PNY C-YANADY PRIETO+ *_ M1' COb1MISSiON # FF 2'. "031 EX?'RES: .Ivlarch 25, 2013 Bonded Thru %=rj Pn7.J underwrtm APPROVED BY: 2017-04-15 )re The foregoing instrument was acknowledge efore by me this 1— day of OC i% 20 / . by who 12E&,E l/,EJZ 1A,4 T who is personally known to me or who has produced identification. NOTARY L, Sign: - Print: as AXIME KOMO e of Florida -Notary Publi Immission # GG 12Rn31 3mmission Expires Ju�ly25, 2021 I Public Works DireLor, or Designee I D O CU1vMNT COVER PAGE FDr those documents not providing the i eauired 3 x 3 mach space on the fist page, this cover page must be atbzhed• An additional recording fee for this page must be remitue d- # C:FN 2 C111R06716 4 3 OR 6K � 1206 Pss 3023-3025 QPgs) RECORDED 11/02r'2011 15a15:26 HARVEY RUVINY CLERK OF COURT MIAMI-DADE C:OUNTYP FLORIDA L----------------------------------- (Space above this Ima reserged for reconding 05ce WC) Do cement Title:vim (Mortgage, Deed,l3tc.) Return Document To / Prepare-d By: gale 2-52-0 (d) on all ... df)=eats prepared ...which ale to be recorded rn the public records of any munty , , . a 3 - mrl' by 3_inrhspaceatthetop iigh'-h=c1comontbefrstpageand al- mrhby3- inchspace2±ffie-EDpigLf-hmdcamex - onearh sib seTu mtpagesh Ubr,15:tblsnl(anL-zserVedfor use by tLat. dry of court CL}UCT 155 P,eV, Dail B Cletus web address; wwW.mlaml-dadeclerk.com 3 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) ls� the following described pro erty (address): 'T" j WV-, � 0<<5,f It ?313� hereinafter referred to as the owner of Legal Description r i4-z-, A-t. %4ot i5— Block 20-2- Subdivision Folio # Requests permission to install (describe work): 0 V-t fe_4j c —C/ ( _ p a-ve r-5 Within the public right of way of (address) la, A/E t 6 K 6_fvvk _ Qfe-s F 3 313 � IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above -mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. LAST PAGE 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this Ib day of T'-z'V1u"-e l Z t�1 b-- Ape SIG ED, EAL AN DELIV ED in the presence of: YANADY PROO h11' CQ1tMISSION # FF 21k031 r xpnRE& MaO.25, 2019 '- 11: yh�Pcbnc lik�de 2 J ignature ) 2016