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RC-17-1597 (2)Miami Shores Village C QMa Public Works Department (305)795-2210 •-- Public works forms are available from the building department, 10050 NE 211 Ave., Miami Shores, FL 3313 PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property Permit#: Master#RC-6-17-1597 Driveway# DS-10-18-3320 18 -3 Name of Applicant (if utility see below): Property Hounds LLC Owner off the following described property: Legal Description: Lot 10-11 Block 1 Subdivision El Portal Folio #; 11-3206-019-0070 Address: 420 NE 91 ST UTILITY NAME: Qualifier/Authorized Agent: Address: Citv: Telephone: Email: State Certification or Registration #: CONTRACTOR NAME: Rare Renovations LLC Qualifier/Authorized Agent: Michael Rares Address: 7021 NW 67 CT State: ZIP: Certificate of Competency # City: Parkland State: FL ZIP: 33067 Telephone: 954-426-8018 Email: contact@raresgroup.com State Certification or Registration #: CBC1260851 Certificate of Competency #:_ Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way: Driveway Type of Work: ❑■ Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: S H Brandt & Associates Address: 5010 N Federal Highway City: Lighthouse Point State: FL Telephone: 954-564-2111 Email: kristina@shbrandt.com Registration #: AR0013352 ZIP: 33064 Value of Work for this Permit: $ 2000.00 Square/Lineal Footage of Work: 516 ***** Fees ***** Permit Fee $ 100.00 Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $ Bond $ (if required) Total Fee Now Due $ `J 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 in 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 accurate and that all work will be done in compliance with applicable laws regulating construction and specifically construction in the right-of-way. "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 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 public works permit with 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 must be posted at the job site for the first inspection which occurs seven (7) days after the public works permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection will be charged. Signature Applicant or Auth&F-fzed Agent The foregoing instrument was acknowledged before me this 30 day of November 2018 , by Michael Rares who is ersonally known to me oho has produced as identification. Signature Company/Utility Agent The foregoing instrument was acknowledged before me this 30 day of November , 2018 , by Michael Rares who a y known to m who has produced —� as identification. Print: Na�ShQ 8604e Print:lVho BbOKf SEAL: SEAL: t�?ice, NATASHABOOKE ��:;, • NATASHABOOKE MYCOMMISSKNI # GG 154422 = �°' - EXPIRES: October 27, 2021 '.• .: MY COMMISSION # GG 154422 P �`-` EXPIRES: Odober 27.2021 'FdF F�?•• Horded Rn Notary Public UndenMllters 'Fu `oc;: F q , Baded ThN Notary PUbtic UrlderMmters ### ######################################## APPROVED BY: lti i ` Public Works Director, or Designee 2017-04-15 m rwrn u. �.. C-, rn.m tr- o • r-- �.M r7 rr u` ti 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) P_rQPertu Nouncac, t_t_C hereinafter referred to as the owner of the following described property (address): 42.'0 NE cl I sT Legal Description Lot I o -1 1 Block I Subdivision E t Portal Folio # _I_I_- 32-OU -ot g - 00i D Requests permission to install (describe work): ari yewal Within the public right of way of (address) ll N Eg 1 ST IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: F 3 ►I W Signature To maintain and repair, when necessary, the above -mentioned items) 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. 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. 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). 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 Mi mi Shores Village (or his fully authorized representative). 1912 1 Owner or Agent � ,��fore g9'ng instrument was acknowled efore me this 30 day of Noyemb .r , 20 IS , by who i persona y known tom r who has produced as identification and who did take an NOTARY �1 LIC• Sign: Print: Nc,taSho PM)%P. My Commission Expires: rr �;. NATASHABOOKS MY COMMISSION # GG 154422 EXPIRES: October 27, 2021 I_ Bonded rnti Notary Public Underw Ilm ,jr war +at as D .d,�catgr !}fkaar 1tlra "X ' rRtva� sb tom► $HAIVERRA BRAZIL #162588