PL-18-2139Miami Shores Village RECEIVED
Building Department AUG 101018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Q
Tel: (305) 795-2204 Fax: (305) 756-8972 Q�(
INSPECTION LINE PHONE NUMBER: (305) 762-4949 �-E� /
FnBC 2014
1 C�
BUILDING Master Permit No. 1� I '" Z 1 S I
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
12(PLUMBING ❑MECHANICAL [:]PUBLICWORKS [-].CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1 3 N
Miami
3
Folio/Parcel#: I ILL(, Oil D Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):TniIr•,, h'14r ;**�� g. , 7tc ��Q, „ h Phone#:� 2 2 - 1 4, L j
Address: 53 /�
City: 01 1 0 M S �U1.�7 S State: _ f l_ Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
I-1 <I� C6,�l Phone#(3
= � 5) 'L..e i 1 3
Address: ��++ O � hl I � ) � �
City: r'_State: Zip: C)�
Qualifier Name: '---I fib -5 , (�
Phone#: CSo5�3�� I 3
c cZ114� 5)Li`&- olu
State Certification or Registration #: , O i Z ( J � 2 Certificate of Competency #: s4
DESIGNER: Architect/Engineer: z Phone#:
Address: City: _State: Zip:
Value of Work for this Permit: $ 15 Square/linear F7Repa
a of Work: 5
Type of Work: ❑ Addition ❑ Alteration El New ir/Replace ❑ Demolition
Description of Work: I)Y'c.iY�_ �\ C. I�A F, � r
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Permit Fee $CCF $
Radon Fee $ Z D B P R $ ' • Z5
Training/Education Fee $
CO/CC $
Notary
Double Fee $
Bond $ �Ob ap
TOTAL FEE NOW DUE
fir' <:::� - <=:::! 15T .
Bonding Company's Name (if applicable)
,Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
/
day of �!v a )I� 20J by
(SPOLN ) who is personally known to
me or who has producedR _Da(Q;�R_ as
identification and who did take an oath.
Signature
CONT OR
The foregoing instrument was acknowledged before me this
day of 20, by
�(L in __LAP , who is personally known to
me or who has produced i as
identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC:
Sign:
Sign:
ONZALEZ
MY COMMISSION # GG 044602
Print: SI
C
g�,
Print:
'* `_ 020
:.}'hrVtiYV°!YY"ti''V'Y - ..
'''F' • 'o? Bonded Thru Notary Public Underwriters
Seal:
ay
Notary Public State of Florida x
Seal:
oY°�e
Sindia Alvarez {
�`
M Commission FF 156750 K.
} �oFw°'Expiresy
0910312018 {
APPROVED BY a �V A Plans'Examiner
Zoning
Structural Review
(Revised02/24/2014)
Clerk
i
American Land Title Association ALTA Settlement Statement - Combined
Adopted 05-01-2015
File No./Escrow No.: 661-000595
Title Alliance of Coral Gables. LLC
Print Date & Time: 07/27/18 11:34 AM
ALTA Universal ID: 1160693
Officer/Escrow Officer: Vanessa Martin
550 Biltmore Way, PH26
Settlement Location:
Coral Gables, FL 33134
Title Alliance of Coral Gables, LLC
550 Biltmore Way, PH 213
Coral Gables, FL 33134
Address:
ler:
er:
lement Date:
ursement Date:
itional dates per state
irements:
53 NE 98th St
Miami Shores, FL 33138
Tania Galloni and Daniel Scarborough
53 NE 98th St
Miami Shores, FL 33138
Kyle Alexander Turner and Kristina Marie Turner
Wells Fargo Bank Na
07/31/2018
07/31/2018
Seller
Description
Borrower/Buyer
Debit
Credit
Debit
Credit
Financial
$681,000.00
Sale Price of Property
$681,000.00
Deposit
$50,000.0
Loan Amount
$453,100.0
Prorations/Adjustments
$316.66
Assessment Taxes from 07/31/2018 thru 12/31/2018
$316.66
$5,117.07
County property taxes from 01/01/2018 thru 07/30/2018
$5,117.07
Loan Charges to Wells Fargo Bank Na
Processing
$985.00
Tax Service
$80.00
Prepaid Interest ($57.41 per day from 07/31/2018 to
08/01/2018)
$57.41
Other Loan Charges
Appraisal $490.00 Borrower -Paid Before Closing
Credit Report $15.43 Borrower -Paid Before Closing
Title Charges & Escrow / Settlement Charges
Title - Closing Fee to Title Alliance of Coral Gables, LLC
$895.00
Copyright 2015 American Land Title Association. rile ;t 001-V V V :)7J
All rights reserved. Page 1 of 4 Printed on: 07/27/18 11:34 AM
Seller
Description
Borrower/Buyer
Debit
Credit
Debit
Credit
$650.00
Closing Fee to Christopher P. Kelley, P.A.
$100.00
Title - Title Search to Title Alliance of Coral Gables, LLC
$32.00
Title - Wire Fee to Title Alliance of Coral Gables, LLC
Title - FL 8.1 Environ Prot to Title Alliance of Coral Gables,
LLC
$25.00
Title - FL 9 Rest, Ease, Min to Title Alliance of Coral Gables,
LLC
$234.05
Title - Lender's Title Insurance $2340.50 to Title Alliance of
Coral Gables, LLC
$25.00
Title - Owner's Title Insurance (optional) $1164.50 to Title
Alliance of Coral Gables, LLC
$3,480.00
Commission
$20,430.00
Real Estate Commission - Listing to Keller Williams Realty
NE
$20,430.00
Real Estate Commission - Selling to Keller Williams Coral
Gables -Coconut Grove
Government Recording and Transfer Charges
$4,086.00
Deed Tax/stamps to Miami -Dade County Clerk of the
Circuit Court
Intangible Tax to Miami -Dade County Clerk of the Circuit
Court
$906.20
Mortgage Tax/stamps to Miami -Dade County Clerk of the
Circuit Court
$1,585.85
Recording Fee (Deed) to Miami -Dade County Clerk of the
Circuit Court
$18.50
Recording Fee (Mortgage) to Miami -Dade County Clerk of
the Circuit Court
$171.50
Payoff(s)
Lender: Payoff of First Mortgage Loan to $43,560.77
SunTrust Consumer Loan Payoff
Box 79232
$43,560.77
Total ($43,560.77)
Miscellaneous
Broker Processing Fee to Keller Williams Realty NE
$299.00
$160.00
Lien Search to Elite Property Research, LLC
Survey to Landmark Surveying & Associates, Inc.
$325.00
Homeowner's Insurance Premium
$3,596.43
$100.00
Water Escrow Hold to Title Alliance of Coral Gables, LLC
Wind Storm Insurance (12 mo.) to Southern Oak Insurance
Company
$4,996.00
Seller
Borrower/Buyer
Debit
I Credit
Debit
I Credit
$94,665.841
$681,316.661
Subtotals
1 $698,996.60
$508,217.07
Copyright 2015 American Land Title Association.
All rights reserved.
Page 2 of 4
File # 661-000595
Printed on: 07/27/18 11:34 AM
Seller
Description
Borrower/Buyer
Debit
Credit
Debit
Credit
Due From Borrower
$190,779.53
$586,650.82
Due To Seller
$681,316.66
$681,316.66
Totals
1 $698,996.60
$698,996.60
Copyright 2015 American Land Title Association. File # 661-000595
All rights reserved. Page 3 of 4 Printed on: 07/27/18 11:34 AM
Acknowledgement ... .
We/I have carefully reviewed the ALTA Settlement Statement and find it to be a true and accurate statement of all receipts and
disbursements made on my account or by me in this transaction and further certify that I have received a copy of the ALTA
Settlement Statement. We/I authorize Title Alliance of Coral Gables. LLC to cause the funds to be disbursed in accordance with
this statement.
Tania Galloni
Daniel Scarborough
Vanessa Martin
STATE OF FLORIDA
)ss
COUNTY OF MIAMI-DADE
Date Kyle Alexander Turner
Date istin e Tu
Da
The foregoing instrument is the true and original document signed before me on July 31, 2018..
VANMA L. MARTIN
NO"leMe • Slate of Florida
• C011lall{a�lt / FF "9715
Mr Ca". E#m del 18, 2020
SaM0tl rolepA NO" Notary Assn..
My commission expires:
�2(57/
Date
7
ate
Copyright 2015 American Land Title Association. File # 661-000595
All rights reserved. Page 4 of 4 Printed on: 07/24/18 4:50 PM
an ( N��Y it'U4t yif 191 y72!!
so ewww. [*A# 1ni IV 5450
3 cowwwft M tt MaW
r MW . 21116 01 tjoiw t
v r im mo
STATE OF FLORIDA
)ss
COUNTY OF 1VIIAMI-DADE )
The foregoing instrument is the true and original document signed before me on July 31, 2018..
NOTARY PUBLIC, State of Florida
Print Name:
My commission expires:
Notice to Owner - Workers' Com
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
nsation Insurance Exemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to
obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees, including the owner, must obtain workers' compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry may elect to be
exempt if:
1. The officer owns at least 10 percent of the stock of the corporation, or in the case of
an LLC, a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State, Division of Corporations; and
3. The corporation is registered and listed as active with the Florida Department of
State, Division of Corporations.
No more than three corporate officers per corporation or limited liability company members are
allowed to be exempt. Construction exemptions are valid for a period of two years or until a
voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use
day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will
be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of
workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
MAHARAI K. GONZALEZ
Signature: ( L—, +_ MY COMMISSION # GG 044602
caner - :a=XPIRES: November 2, 2020
%F F �P Bonded Thru Notary public Underwriters
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this (S day of , 20 l
By Lo ) I O p 1 who is personally known to me or has produced
1 I, v as identification.
Notary:
SEAL:
A SUPER SEPTIC & DRAIN FIELD INC.
CC: SR0161772
PHONE: 305-364-0113
DATE: 9' �-IiS
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
7701 WEST 18 LANE
HIALEAH, FLORIDA 33014
Licensed and Insured
E-MAIL: ASUPERSEPTIC@GMAIL.COM
WWW.ASUPERSEPTIC.COM
FAX: 305-364-0349
BEFORE ME THIS DAY PERSONALLY APPEARED, WHO
BEING DULY SWORN, DEPOSES AND SAYS:
THAT HE OR SHE WILL BE THE ONLY PERSON WORKING ON THE PROJECT AT:
-S3 A,C, 19ffi13�r-;K
Contractor Signature:
Ir`
SWORN TO (OR AFFIRMED) AND SUBSCRIBED TO ME THIS DAY OF
2018, BY: jo'n V-1 .�
'—
MA XMI Y, ONG7ALEZ �
GG 044602
MY COMMISSION #
Novemr22p20
be,
S
Publi
--
B0rPdSRNNotary
PERSONALLY KNOWN
OR PRODUCED IDENTIFICATION -:4
TYPE OF INFORMATION PRODUCED
At��4p -
PRINT, TYPE, OR STAMP NAME OF NOTARY
)OB No. 12-1220
DATE OF SURVEY: Dec.10, 2012
REVISION DATE:
TIFY T is
ALINA AND KRISTINA VOGTNER
TLC TITLE COMPANY OF FLORIDA
WFG NATIONAL INSURANCE COMPANY
WELLS FARGO BANK, ITS SUCCESSORS
AND/OR ASSIGNS, A.T.I.M.A.
NE
r
12
NE
SITE ADDRESS: 53 NE 98th STREET, MIAMI SHORES FLORIDA 33138
0
5' Sidewalk,
THIS IS PAGE 1 OF 2, NOT VALID WITHOUT ALL PAGES.
LEGAL DESCRIPTION:
LOT 18 AND THE WEST j OF LOT 19, BLOCK 8 OF MIAMI SHORES SECTION No. 1
SUBDIVISION, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK
10 AT PAGE 70, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA.
WE HEREBY CERTIFY THAT THE ATTACHED SKETCH OF 'BOUNDARY SURVEY' AND THE SURVEY
MAP RESULTING THEREFROM OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND CORRECT
REPRESENTATION OF A FIELD SURVEY MADE UNDER MY DIRECTION AND MEETS THE INTENT OF
THE APPLICABLE PROVISIONS OF THE 'MINIMUM TECHNICAL STANDARDS FOR LAND SURVEYING
IN THE STATE OF FLORIDA* PURSUANT TO RULE 5J-17 OF THE FLORIDA ADMINISTRATIVE
CODE AND ITS IMPLEMENTED LAW, CHAPTER 472.027, OF THE FLORIDA STATUTES.
HOUSE PICTURE
REALTOR INFORMATION:
PREMIER REALTY GROUP
Phone:(954) 32$M7
Sandra Lynch, Realtor
E
AMERICAN SERVICES OF MIAMI, CORP. E
Consulting Engineers. Planners. Surveyors -'a
N D
9360 S.W. 72nd STREET, SUITE 200 r o B
Y
MIAMI, FLORIDA 33173 o E PIno a
® PHONE: (305)598-5101 PR §sTONAo
FAX: (305)598-8627 aO' A
LB 6683 ASOMIAMI.COM suRVE
DATE: 2012
�L
Title Company
of Florida, Inc.
The Title Company That Cares
www.tl cti tl eflorida.com
Tender, loving closings
throughout Florida
V J
Carol J. Saxton
Chief Executive Officer
4801 S. University Drive
Suite 226A
Davie, Florida 33328
Phone: (954) 434-4339
Toll Free:,(866) 293-4339
Fax: (954)4.34-5187
E-nu il: csaxamf9tkVIL* 1&.mn
SURVEY REPORT: 124220
THIS IS PAGE 2 OF 2, NOT VALID WITHOUT ALL PAGES'.
ENCROACHMENTS AND OTHER POINTS OF INTEREST:
THIS DRAWING IS THE PROPERTY OF AMERICAN SERVICES OF MIAMI, CORP. AND
-THERE ARf NO VISIBLE ENCROACHMENT OF THE SUBJECT PROPERTY
SHALL NOT BE USED OR REPRODUCED, IN WHOLE, OR IN PART, WITHOUT PERMISSION
-)-HE SUBJECT PROPERTY IS WITHIN A FLOOD ZONE X (SEE'NOTE 1)
OF AMERICAN SERVICES OF MIAMI, CORP.
-THERE ARE NO PLATTED UTIL. EASEMENTS ON THE SUBJECT PROPERTY
NOTHING HEREON SHALL BE CONSTRUED TO GIVE ANY RIGHTS OR BENEFITS TO
ANYONE OTHER THAN THOSE CERTIFIED.
NOT VALID WITHOUT THE SIGNATURE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER
JOB SPECIFIC.SURVEYOR NOTES:
THE PROPERTY DESCRIBED ON THIS SURVEY DOES;NOT,LIE WITHIN A SPECIAL HAZARD AREA AS DEFINED -BY THE
FEDERAL EMERGENCY MANAGEMENT AGENCY; THE PROPERTY LIES WITHIN A`FLOODZONE "X" OF THE FLOOD
INSURANCE RATE MAP IDENTIFIED AS COMMUNITY PANEL No. 120652-0302L, WITH AN EFFECTIVE DATE OF
SEPTEMBER 11, 2009. BASE FLOOD ELEVATION OF N/A FEET (NGVO)
2Q LAND AREA OF SUBJECT PROPERTY: 8,625 SF
3Q ELEVATIONS ARE BASED ON THE NATIONAL GEODETIC VERTICAL DATUM (NGVD) OF 1929, AS PER MIAMI-DADE COUNTY
BENCH MARK No. N/A, WITH AN ELEVATION OF N/AfEET
® BEARINGS SHOWN HEREON ARE BASED ON AN ASSUME MERIDIAN OF NORTH-SOUTR,'BEING THE RECORDED BEARING
FOR THE CENTERLINE OF NE 1st AVE., AS SHOWN ON PLAT BOOK 10 AT PAGE 70 OF THE PUBLIC VLCORD OE.....
MIAMI-DADE COUNTY FLORIDA. ' ' "" ""
...... .. . ....
GENERAL SURVEYOR NOTES: '....' :""' ....
THE SHOWN LEGAL DESCRIPTION USED TO PERFORM THIS BOUNDARY SURVEY WAS PROVIDED BY THE CLIM": ."' •. ""
SURVEY IS BASED ON RECORDED INFORMATION PROVIDED BY CLIENT. NO SPECIFIC SEARCH OF THE PUBL.VIZMD HAS BEEN MADE BY •
OUR OFFICE. ' :... %
UNLESS OTHERWISE NOTED, AN EXAMINATION OF THE ABSTRACT OF TITLE WAS NOT DONE BY THE SIGNING 6URVEYOR TO.DWERMIA'"
WHICH INSTRUMENTS, IF ANY ARE AFFECTING THE SUBJECT PROPERTY. • • •
THIS SURVEY IS EXCLUSIVELY FOR THE USE OF THE PARTIES TO WHOM IT WAS CERTIFIED.
PURSUANT TO RULE 61G17-6 OF THE FLORIDA ADMINISTRATIVE CODE THE EXPECTED USE OF LAND IS SUBURBAN, THE MINIMUM
RELATIVE DISTANCE ACCURACY FOR THIS TYPE OF SURVEY IS 1 FOOT IN 7,500 FEET. THE ACCURACY OBTAINED BY MEASUREMENT AND
CALCULATIONS OF CLOSED GEOMETRIC FIGURES WAS FOUND TO EXCEED THIS REQUIREMENT.
THERE ARE NO VISIBLE, ABOVE GROUND ENCROACHMENTS (a)'BY THE IMPROVEMENTS OF THE SUBJECT'PROPERTY UPON ADJOINING
PROPERTIES, STREETS OR ALLEYS, OR (b) BY THE IMPROVEMENTS OF THE ADJOINING PROPERTIES,STREETS OR ALLEYS UPON THE
SUBJECT PROPERTY OTHER THAN THOSE SHOWN ON THIS BOUNDARY SURVEY.
THERE ARE NO VISIBLE EASEMENTS OR RIGHT-OF-WAY OF WHICH THE UNDERSIGNED"HAS BEEN ADVISED OTHER THAN THOSE SHOWN
ON THIS SURVEY.
THE MAP OF SURVEY IS INTENDED TO BE DISPLAYED AT THE SHOWN GRAPHIC SCALE IN ENGLISH UNITS OF MEASUREMENT. IN SOME
CASES GRAPHIC REPRESENTATION HAVE BEEN EXAGERATED TO MORE CLEARLY ILLUSTRATE A PARTICULAR AREA WHERE DIMENSIONS
SHALL HAVE PREFERENCE OVER GRAPHIC LOCATION.
THE ELEVATIONS (IF ANY) OF WELL -IDENTIFIED FEATURES AS DEPICTED ON THIS SURVEY AND MAP WERE MEASURED TO AN ESTIMATED
VERTICAL POSITIONAL ACCURACY OF YlD FOOT FOR NATURAL GROUND SURFACES AND Y1DD FOOT FOR HARDSCAPE SURFACES, INCLUDING
PAVEMENT, CURBS, SIDEWALKS AND OTHER MANMADE STRUCTURES.
THE SURVEYOR MAKES NO REPRESENTATION AS TO OWNERSHIP, POSSESSION OR OCCUPATION OF THE SUBJECT PROPERTY BY ANY
ENTITY OR INDIVIDUAL.
ANY FEMA FLOOD ZONE INFORMATION PROVIDED ON THIS SURVEY IS FOR INFORMATIONAL PURPOSE ONLY AND IT WAS OBTAINED AT
WWW.FEMA.COM.
IF YOU ARE READING THIS BOUNDARY SURVEY IN AN ELECTRONIC FORMAT, THE INFORMATION CONTAINED ON THIS DOCUMENT IS
ONLY VALID IF THIS DOCUMENT IS ELECTRONICALLY SIGNED AS SPECIFIED IN CHAPTER 53-17.062 (3) OF THE FLORIDA ADMINISTRATIVE
CODE. IF THIS DOCUMENT IS IN PAPER FORMAT, IT IS NOT VALID WITHOUT THE SIGNATURE AND ORIGINAL RAISED SEAL OF THE
PROFESSIONAL LAND SURVEYOR AND MAPPER OF RECORD.
ABREVIATION (IF ANY APPLIED)
SURVEYORS. L-EGEND._(IF.ANY APPLIED)
A - CURVE P/W - PARKWAY
A/C - AIR CONDITIONING UNIT P.O.B. - POINT OF BEGINNING
Q BOUNDARY LINE ® CATCH BASIN
ASPH. - ASPHALT P.O.C. - POINT OF COMMENCEMENT
B.M. - BENCH MARK P.C. - POINT OF CURVATURE
STRUCTURE (BLDG.) ® MANHOLE
Blk/Cam.- BLOCK CORNER P.I. - POINT OF INTERSECTION
CALC.(C) - CALCULATED P — PROPERTY LINE
CONCRETE BLOCK WALL O.E. OVERHEAD ELECT.
CB - CATCH BASIN P.P. - POWER POLE
C.B.S. - CONCRETE BLOCK STRUCTURE P,R M = PERMANENT REFERENCE
`
METAL FENCE AV POWER POLE
CL - CLEAR MONUMENT
CONC. - CONCRETE P.T. = POINT OF TANGENCY
WOODEN FENCE �- LIGHT POLE
D.M.E. - DRAINAGE MAINT. EASEMENT RAD. - RADIAL
0 - DIAMETER REC. (R) - RECORDED
CHAIN LINK FENCE
EASMT. - EASEMENT RES. — RESIDENCE
WOOD DECK/DOCK HANDICAP SPACE
ELEV. — ELEVATION R/W - RIGHT OF WAY
ENC. - ENCROACHMENT SEC. - SECTION
F.D/H - FOUND DRILL HOLE S.D/H - SET DRILL HOLE
ASPHALTED,AREAS HANDICAP SPACE '.
F.H. - FIRE HYDRANT S.N/D = SET NAIL AND DISC
CONCRETE — — — EASEMENT LINE
F.N/D - FOUND NAIL AND DISC S.I.P. - SET IRON PIPE
F.I.P. - FOUND IRON PIPE S.R.B. - SET REBAR
BRICKS OR PAVERS N WATER VALVE
F.S. - FOUND SPIKE STY - STORY
L.P. - LIGHT POLE SWK. - SIDEWALK
ROOFED"AREAS
MEAS.(M) — MEASURED T.O.P. - TOP OF BANK
�
MH - MANHOLE U.E. — UTIL. EASEMENT
,.:
® WATER`(EDGE OF WATERWAYS)
M - MONUMENT W.P. = WOODEN POLE
Y - MONUMENT LINE $ -SECTION LINE
NTS - NOT TO SCALE
I
'
Li``_ fad°T^••fi' ...�[' Ci... Z%i�E?L'1'Li
O[�,.; :`i'n E'&,;iAGIG .; TREATMENT Al D DISPOSAL
SYSTEM
PF'RMI:' :.S�''i F 7469
APPLICATION u AP1358023
,,_ oL ..... .
FEE PAID. -
RECEIPT #:
DOCUMENT #::a'.'i138:s(0-6
R E P A
ill R
PSRM7,, FOR: OSTDS Repair At?E COUNTY FtrALn.f REPq p�
KYL'c H.LEXANDER TURNER
PRCFnRTY ADDRESS: 53 NE 98 St Miami, FL 33138
LOT: i8-1J BLOCK: 8 SUBDIVISION:
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY :,:D #: 11-3206-013-1140
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
391.0055, F.S., AND CY.APTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
••••
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERSAL FACTS,
WHICH SERVED AS A BASIS FOR,' ISSUANCE OF THIS PERMIT, REQUIRE THE •APPLICANT• TO MODIFY 'I•'I�
PER14102 .:.PPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEJN•J ••• •• • MADE *AAA -AND VOID.
••••••
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIArt�F:•WITH OTHER FEDERAL
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. •••• • • �••••:
•
• •••• • •••••
SY,"'^••;•: ..,..-.-,N ANND '•'.PI"CIFICATIO'sdS
•••••• •••• •••••
T (
900 ) GALLONS / GPD Septic Tank
CAPACITY
• • • • • • • • •
A (
0 ) GALLONS / GPD
CAPACITY
•
N [
0 ) GALLONS GREASE INTERCEPTOR CAPACITY
• • ••••�•
[MAXIMUM CAPACITY SINGLE TAN4:125A GALLONS?" • •
K [
1 GALLONS DOSING TANK CAPACITY [
] GALLONS @ [
] DOSES PIR.241 .*:iRS • •#j;umps 1: •"';
• • •
•• •
D i t2i ] SQUARZ FEET
R C SQ17F.RE FEET
A TYPE SYSTEM: [X.1
I CaLIFiGUR?1TION: [:t)
rT
New Drainfield SYSTEM
STANDARD
TRENCH
[ j FILLED
] BED
SYSTEM
[ ] MOUND [ ]
F LOCATION OF BENCHMARK: FFE 13.3
1 LLEVAT i ON OF ':?? :i'OSED SYSTEM SITE [ 25.20 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 61.20 ) [ INCHES 1 FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D E
0
T
H
E
R
'ILL REQUIRED: [ 0.00 ] INCHES EXCAVATION REQUIRED: [ va.uu j IW.;nkib
1 -EXISTING 900 gal septic tank .With and approved filter TO REMAIN.
2.- The licensed contractor installing the system is responsible for installing the minimum category of tank in accoraance
with s. 64E-6.013(3)(r) FAC.
:;.- InLitali 225 sf. of Grainfield in. —TRENCH... configuration.
4.- instail 12 " of slightly limited soil at the bottom of the drainfield.
5 - to:Fri eie;va,tion and Bottom of drainfield to be no less than 8.70' & 8.20' NGVD respectively
THIS PERMIT IS NOT FOR ANY ADDITIONS.
,nil hnrinn arliaceni to the drainfield excavation W 0'_
SPECTL'ICF:I] O1QS BY; lilAmin IsRW Ann. Prior to Final Ap rove
ns Or I It tuitpp 2tiC•S> Uo ing an Evils; j
APPr•.Ov^T7 ti.Y:Z .^,ult5 In he nri Iris► silo Cvalt TjbtLsutHl9itrlQftonmental Specialist II Dade CHD
s=1r YTTeuttt7�t will ge assessed if ttre r n du:r
DATE ISSC7E'D: 08/03/2( the artanged time. EXPIRATION DATE: 11/01/2018
DH 4016E CF/09 1,Ob^o1.et=s =11 pravious editions which may not be used)
Ina -. n_.por,.� d.: 64.F.-6.003, PAC Page 1 of 3
..,.. AP135e023 PF1nptnarF
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR CONSTRUCTION PERMIT
Permit Application Number.
---------------------------PART II - SITEPLAN---------------------------
Scale• Each block reDresents 10 feet and 1 inch = 40 feet
Mill
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Notes: REPAIR, REPLACING EXISTING 300 S.F BED D.F, WITH 225 SY IN TRENCH CONFIGURATION D.F
NEW BUYER, WATER CONSUMPTION UNOBTAINABLE.
Site Plan submitted by:
CONTRACTOR
Plan Approved Not Approved Date
By
8-2-18
County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 2 of 4
(Stock Number: 5744-002-4015-6)
�,�� •�� DIVISION OF
Environmental Health
Florida Health
�O Miami -Dade County �0 AQQ OSTDS/Well Division
�.� I1805 SW 26th Street •Miami, FL �13175 O
Inspector frN f' y� Date _ �d
Address �3 /{�E"r i N! OSTDS #
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