PL-19-182�►,� DIVISION OF
°a Environmental Health
Florida Health
Miami -Dade County
eQ� OSTDS/Well Division
11805 SW 26th Street • Miami, FL 3
Inspectorye�ef
Address
Comments:
Signature
3175
Date
OSTDS #
PL -D - 19 - 18Z
Permit NO.: PL-01-19-192
Miami Shores Village-, Permit Type: Pluming- Residential
10050 NE 2 Ave
Miami Shores FL 33138 ft'u� Work Classification: Septic/Drainfi%li
305-795-2204 PermitStrrtus: Approved
Issue Date:-02/01/209 Expiration: 07/31/2019
Location Address Parcel Number
165 NW 96TH ST, Miami Shores, FL 33150 1131010250130
Contacts
Description: DRAIN FIELD REPAIR & SEPTIC TANK Valuation: $ 8,000.00 Inspection Requests:
DEVELOPMENT 305-762-494
Total Sq Feet: 0.00
Fees
LISETTE JACOB0 Owner
165 NW 96 ST
Home: 3055099474
A SUPER SEPTIC & DRAIN FIELD INC Contractor
BRYAN K ZERO
7701 W 18 LN, HIALEAH, FL 33014
$50.00
CCF
$4.80
Description: DRAIN FIELD REPAIR & SEPTIC TANK Valuation: $ 8,000.00 Inspection Requests:
DEVELOPMENT 305-762-494
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$4.80
DBPR Fee
$4.20
DCA Fee
$2.80
Education Surcharge
$1.60
Permit Fee
$230.00
Scanning Fee
$9.00
Technology Fee
$7.00
Total:
$309.40
Payments
Date Paid Amt Paid
Total Fees
$309.40
Credit Card
01/25/2019 $50.00
Credit Card
02/01/2019 $259.40
Amount Due:
$0.00
Building Department Copy
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 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. Futhermore, I authorize the above named contractor to do the work stated.
Signature: gWner / Applicant / Contractor / Agent
February 01, 2019 Page 2 of 2
BUILDING
PERMIT APPLICATION
❑ BUILDING
PLUMBING
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
", Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
❑ ELECTRIC Ej ROOFING
Master Permit No
Sub Permit No.
rt ECE` VE
G
JgN25?OlJ
. LC�4
FBC 2011
REVISION [::] EXTENSION RENEWAL
MECHANICAL PUBLIC WORKS [:] CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /0 /z/ �)/3ez'= /
City: Miami Shores County:/
2¢� Miami Dade zip: .33/5 0
Folio/Parcel#: //l /D/- Dom- d /3 0 Is the Building Historically Designated: Yes NO
Occupancy Type; Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): /1/1 TTf ✓A Pv 690 Phone#: DO 9 ^ W 7'f
Address: /� 5� /L/ w. 96 _977ie.e T
City: W;"7 op 47) 311 g -3 State: /=/o f'P/ -114 Zip: 3314'6
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: !�q J p� t ))A/ A) r � --FiP. Phone#: 3CL5 - _20- 0//-21
Address: �Z%a / W � T X n ne
City: L 14- 1'P a N State: El AA � a Zip: ')00) 4
Qualifier Name
.L
Certification or
i U Phone#: 3 Q5- w- O/i 3
tion #:-S fi0.16 )'r7' a- S � � �6 Ce Acaeof Competency #:
DESIGNER: Architect/Engineer:
Address
State: Zip:
Value of Work for this Permit: $ 6f /19' -- Square/Linear Footage of Work: -VQ 6
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee $ so Permit Fee $
Scanning Fee $ �-Y Radon Fee $
Technology Fee $
Structural Reviews $
Training/Education Fee $
CCF $ CO/CC $
DBPR $
Notary $.
Double Fee $
Bond $ 56c). 00
TOTAL FEE NOW DUE $ Ls
(Revised02/24/2014) ��
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable) _
Mortgage Lender's Address
City
li
Zip
Zi
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.
SignatureAW euuk 3A C&,
OWNER or AGENT
The foregoing instrument was acknowledged before me this
_� day of CX 20 by
Lo is personally known to
me or who has produ ed 0 1iC� �� as
identification and who did take an oath.
NOTARY PUBLIC:
Signature -)�F Z"
CON TOR
The foregoing instrument was acknowledged before me this
baday of CC T , 20 �, by
n1 who is personally known to
me or who has produced 1 as
identification and who did take an oath.
NOTARY PUBLIC:
—�"` "" MY COMMISSION # GG 044602
Prin : MY COMMISSION # GG 044602 Print: *:
EXPIRES: November 2, 2020 +. P?
g.•' Bonded Thru Notary Public underwriters
Seal: fiq 2• Bonded Thru Notary Public Underwriters Seal:
APPROVED BY i���� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Ivotice to uwner — worKers, compensation 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.
Signature: &f, v
Owner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this day of OcT 20—b.
who is personally known to me or has produced
fication.
,,, "(49•., MAHARAI K. GONZALEZ
MY COMMISSION # GG 044602
EXPIRES: November 2, 2020
Bonded Thru Notary Public Underwriters
A SUPER SEPTIC & DRAIN FIELD INC.
CC:SR0161772
PHONE: 305-364-0113
DATE: /0-11-- /
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
7701 WEST 18 LANE
HIALEAH, FLORIDA 33014
Licensed and Insured
E-MAIL: ASUPERSEPTIC@GMAIL.COM FAX: 305-364-0349
WWW.ASUPERSEPTIC.COM
BEFORE ME THIS DAY PERSONALLY APPEARED, WHO
BEING DULY SWORN, DEPOSES AND SAYS:
THAT HE OR SHE WILL BE TH ONLY PEgg,,SON WORKING ON THE PROJECT AT:
I d ,s y, w q6 S lr-"+ -3 7 t .�-o
Contractor Signature: --Afc��
SWORN TO (OR AFFIRMED) AND SUBSCRIBED TO ME THIS _� DAY OF
, 2018, BY: �Ann g - 1(_(--
PERSONALLY KNOWN
• � P� •• MAHARAI K. GONZALEZ c
TYPE OF INFORMATION PRODUCED
MY COMMISSION # GG 044602
OR PRODUCED IDENTIFICATION
.*:
EXPIRES: November 2, 2020
Bonded Thru Notary Public Underwriters
� S�
PRINT, TYPE, OR STAMP NAME OF NOTARY
I
BOUNDARY SURVEY
SCALE = 1"= 20'
LOT -3 LOT -4 LOT -5
BLOCK -3 BLOCK -3 BLOCK -3
R
0 15'ALLEY (N-A.P.) 10' ASPHALT a S
JAN 2.5 o PVMT. 30
RLP 3/4'MI75.uu U.P.
NO CAP
0.05'CL.
F
4' C.L.F.
m
p 3
O O
6' W.F. p i
O p
h 4' C.L.F.
o' 0.30'CL.
I.-Od
C.S. ' . CONC. 'fj �L
STEPS ^/
A/C101
-Z G
23.60'
c 1 .7,4' � cO o
LOT - 14 ^ 16.45' "' LOT - 12
BLOCK -3 �� BLOCK -3
ONE STORY n `1, +�
RES. # 165 V
.a
® m
C.S . Y N LOT - 13 Cd
U eh BLOCK -3
3
0.05 ENCR. ; m
0.45'CL. Q
0.46'CL. 17.66' a 13.55' oo
11.35'N L. c4 15.15' 17.29'
4'1.F. C.B.W.
Y
o N U N o r1
U v
0
200' °' CD
P.R.M.. F.LP 3(4" " 75.00' F.I.P 3(4" i
F.I.P 314" NO CAP 5' CONC. SWK' ANCHOR NO CAP
NO CAP vi
U.P. a Z:
11' PWY a <c
0000
•
ca • • 0000 0000 •
p •• • • • •
tt � 0000••
•0.000 • 6
00• •
16' ASPHALT •
0000•• • • •
PVMT. .••• •
0000 •• • � • •
•
0000 • H 0000
N, W. 96th STREET . • .... J ..:. •
•o• Q
15'MEDIAN 0000•• • O •
• 0000 •
16'ASPHALT 0000••
PVMT. • • • 0000 •
SURVEYORS NOTE:
A) Overhead Utility Line Encroaching onto Subject Property on the Northeast side of Property.
B) Wood Fence Encroaching onto Neighbor's Property (Lot, 14 Block l) on the West side.
rLm i Duum 4L, mut oC, ur I tit VUbLIU Kt:UUKDS Uh MIAMI-DADE COUNTY, FLORIDA.
LEGEND TYPICAL
A = ARC FNIP. = FEDERAL NATIONAL INSURANCE RAD. =RADIUS OF RADIAL
—OK- OVERHEAD UTILITY LINES
A/C = AIR CONDITIONER PAD PROGRAM RGE. = RANGE
PROPERTY ADDRESS: 165 NW 96 ST, MIAMI SHORES, FL 33150
A.E. = ANCHOR EASEMENT IN &EG. = INGRESS AND EGRESS R P. = RADIUS POINT
ZZZZ C B.S. = WALL ICBW)
A/R = ALUMINIUM ROOF EASEMENT R.0 E. = ROOF OVERHANG.
FOR: LISETTE JACOBO
GL F =CHAIN LINK FENCE
ASPH. - ASPHALT L.M.E. = LAKE MAINTENANCE EASEMENT RM/ = RIGHT-OF-WAY
B.C. = BLOCK CORNER L P. = LIGHT POLE SEC. = SECTION
LOCATION SKETCH Scale 1" = NT.S.
&C R. = BROWARD COUNTY RECORDS M. = MEASURED DISTANCE S I.P. = SET IRON PIPE L B #6044
-r , W F. = WOOD FENCE
B.M, = BENCH MARK M/H = MANHOLE SWK. = SIDEWALK
B.O.B. = BASIS OF BEARINGS N.A.P. = NOT A PART OF T = TANGENT
• 0.00 = EXISTING ELEVATIONS
C =CALCULATED NGVD = NATIONAL GEODETIC VERTICAL TWP = TOWNSHIP
C . =CATCH BASIN DATUM U E. = UTILITY EASEMENT
C.B.W. = CONCRETE BLOCK WALL N.T.S. = NOT TO SCALE U.P. = UTILITY POLE
SURVEYOR'S NOTES
CH = CHORD O.H.L. = OVERHEAD UTILITY LINES W.M. = WATER METER
CH.B. = CHORD BEARING OR .B. = OFFICIAL RECORD BOOK W.R, =WOOD ROOF
1) IF SHOWN, BEARINGS ARE REFERRED TO AN
ASSUMED
CL = CLEAR O/S = OFFSET W.S. =WOOD SHED
MERIDIAN, 8Y SAID PLAT IN THE DESCRIPTION THE
.
C.LF. = CHAIN LINK FENCE DVH. = OVERHANG
1
h
C. M.E = CANAL MAINTENANCE P.B. = PLAT BOOK = ANGLE
COUNTY, TOWNSHIP MAPS
EASEMENTS P,C. =POINT OF CURVE =CENTRAL ANGLE
2) THIS IS A SPECIFIC PURPOSE SURVEY.
h / .2 6
3) THE CLOSURE IN THE BOUNDARY SURVEY IS ABOVE
T =CENTER LINE
C.P. = CONCRETE PORCH PL. = PLANTER
1'7500 FT.
C.S. = CONCRETE SLAB P1 S. = PROFESSIONAL LAND =MONUMENT LINE
4) IF SHOWN, ELEVATIONS ARE REFERRED TO
O.E. =DRAINAGE EASEMENT SURVEYOR
MIAMI-DADE COUNTY.
D.M.E. = DRAINAGE MAINTENANCE P.0 B.. = POINT OF BEGINNING
7.
75• •
ft/ ie s'
ENCR. = ENCROACHMENT P.P.S.. = POOL PUMP SLAB
E T.P = ELECTRIC TRANSFORMER PAD RR . = POINT OF REVERSE CURVE
F.F.E. = FINISHED FLOOR ELEVATION PRM = PERMANENT REFERENCE
(
F.I,P = FOUND IRON PIPE PT =POINT OF TANGENCY
SURVEYOR'S
h N f
-CERTIFICATION
F.N. = FOUND NAIL PWY = PARKWAY
I HEREBY CERTIFY THAT THIS "BOUNDARY SURVEY" OF
F.N.D = FOUND NAIL & DISK R. =RECORD DISTANCE
Jo'
SURVEYED AND DRAWN UNDER MY SUPERVISION,
.9
y
.5J
AS SET FORTY BY THE FLORIDA EM(J"Oj:
- THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY
PROFESSION*L LAIiD SJJRVEYORS IN CHAPTER 61G1•/�,• •
- THE PURPOSE OF THIS SURVEY IS FOR USE IN OBTAINING TITLE INSURANCE AND FINANCING. AND SHOULD NOT BE
FLORIDA ADMINISfRATN'E CODE OURSUANT TO 472.027, •
USED FOR CONSTRUCTION PURPOSES.
FLORIDA STATUTES. • • • • • •
- EXAMINATIONS OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY,
• • • • • • • • • • •
AFFECTING THE PROPERTY, THIS SURVEY IS SUBJECT TO DEDICATIONS, LIMITATIONS, RESTRICTIONS, RESERVATIONS
OR EASEMENTS OF RECORD, AND LEGAL DESCRIPTIONS PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY.
BOUNDARY SURVEY MEANS A DRAWING AND / OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK PERFORMED IN
•
•••• •
• • • •
- THE FIELD, COULD BE DRAWN AT A SHOWN SCALE AND I OR NOT TO SCALE.
• AG
EASEMENTS AS SHOWN ARE PER PLAT BOOK. UNLESS OTHERWISE SHOWN
• • • : A
BY. (lh'W J • • •
SUBJECT
EORGE IBARRA (6FlTE�€ ILD W�hK)
- ARCHITECTS SHALL VERIFY ZONING REGULATIONS, RESTRICTIONS AND SETBACKS. AND THEY WILL BE RESPONSIBLE
• • • • • • • • • • • • •
- FOR SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR APPROVAL FOR AUTHORIZATION TO
PROPERTY
AUTHORITIES IN NEW CONSTRUCTIONS, UNLESS OTHERWISE NOTED THIS FIRM HAS NOT ATTEMPTED TO LOCATE
• • • •
PROFESSION �L�+ ND SURVEYOR NO. 2534
FOOTING AND/OR FOUNDATIONS.
e.
-- _A/W -,S-
ST-
BEAR THE EMBOSSED &EAL OF TjiE ATTESTING LANA • •
- THIS PLAN OF SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED.
•
SURVEYOR). • • • • • •
6
6 7/ 23
i
• • • •
- THE SURVEYOR MAKES NO GUARANTEES AS TO THE ACCURACY OF THE INFORMATION BELOW. THE LOCAL F. E. M.A.
• • • • • • •
; G
ABBREVIATION AND MEANING
LEGEND TYPICAL
A = ARC FNIP. = FEDERAL NATIONAL INSURANCE RAD. =RADIUS OF RADIAL
—OK- OVERHEAD UTILITY LINES
A/C = AIR CONDITIONER PAD PROGRAM RGE. = RANGE
A.E. = ANCHOR EASEMENT IN &EG. = INGRESS AND EGRESS R P. = RADIUS POINT
ZZZZ C B.S. = WALL ICBW)
A/R = ALUMINIUM ROOF EASEMENT R.0 E. = ROOF OVERHANG.
AIS = ALUMINIUM SHED L F E. = LOWEST FLOOR ELEVATION EASEMENT
GL F =CHAIN LINK FENCE
ASPH. - ASPHALT L.M.E. = LAKE MAINTENANCE EASEMENT RM/ = RIGHT-OF-WAY
B.C. = BLOCK CORNER L P. = LIGHT POLE SEC. = SECTION
-0-p I F =IRON FENCE
&C R. = BROWARD COUNTY RECORDS M. = MEASURED DISTANCE S I.P. = SET IRON PIPE L B #6044
-r , W F. = WOOD FENCE
B.M, = BENCH MARK M/H = MANHOLE SWK. = SIDEWALK
B.O.B. = BASIS OF BEARINGS N.A.P. = NOT A PART OF T = TANGENT
• 0.00 = EXISTING ELEVATIONS
C =CALCULATED NGVD = NATIONAL GEODETIC VERTICAL TWP = TOWNSHIP
C . =CATCH BASIN DATUM U E. = UTILITY EASEMENT
C.B.W. = CONCRETE BLOCK WALL N.T.S. = NOT TO SCALE U.P. = UTILITY POLE
SURVEYOR'S NOTES
CH = CHORD O.H.L. = OVERHEAD UTILITY LINES W.M. = WATER METER
CH.B. = CHORD BEARING OR .B. = OFFICIAL RECORD BOOK W.R, =WOOD ROOF
1) IF SHOWN, BEARINGS ARE REFERRED TO AN
ASSUMED
CL = CLEAR O/S = OFFSET W.S. =WOOD SHED
MERIDIAN, 8Y SAID PLAT IN THE DESCRIPTION THE
.
C.LF. = CHAIN LINK FENCE DVH. = OVERHANG
PROPERTY. IF NOT, THEN BEARINGS ARE REFERRED TO
h
C. M.E = CANAL MAINTENANCE P.B. = PLAT BOOK = ANGLE
COUNTY, TOWNSHIP MAPS
EASEMENTS P,C. =POINT OF CURVE =CENTRAL ANGLE
2) THIS IS A SPECIFIC PURPOSE SURVEY.
CONC. = CONCRETE P.C.C. = POINT OF COMPOUND CURVE
3) THE CLOSURE IN THE BOUNDARY SURVEY IS ABOVE
T =CENTER LINE
C.P. = CONCRETE PORCH PL. = PLANTER
1'7500 FT.
C.S. = CONCRETE SLAB P1 S. = PROFESSIONAL LAND =MONUMENT LINE
4) IF SHOWN, ELEVATIONS ARE REFERRED TO
O.E. =DRAINAGE EASEMENT SURVEYOR
MIAMI-DADE COUNTY.
D.M.E. = DRAINAGE MAINTENANCE P.0 B.. = POINT OF BEGINNING
EASEMENTS P.O.C.. = POINT OF COMMENCEMENT
BM# ELEV. FEET OF N V D OF 1929.
DRIVE = DRIVEWAY P.P =POWER POLE
ENCR. = ENCROACHMENT P.P.S.. = POOL PUMP SLAB
E T.P = ELECTRIC TRANSFORMER PAD RR . = POINT OF REVERSE CURVE
F.F.E. = FINISHED FLOOR ELEVATION PRM = PERMANENT REFERENCE
F.H. = FIRE HYDRANT MONUMENT
F.I,P = FOUND IRON PIPE PT =POINT OF TANGENCY
SURVEYOR'S
F.I.R. = FOUND IRON ROD PVMT =PAVEMENT
-CERTIFICATION
F.N. = FOUND NAIL PWY = PARKWAY
I HEREBY CERTIFY THAT THIS "BOUNDARY SURVEY" OF
F.N.D = FOUND NAIL & DISK R. =RECORD DISTANCE
THE PROPERTY DESCRIBED HEREON, AS RECENTLY
SURVEYED AND DRAWN UNDER MY SUPERVISION,
LEGAL NOTES TO ACCOMPANY SKETCH OF SURVEY 1"SURVEY•)•
COMPLIES WITH THE MINIMUM TE Aleft? jTANDARDS
AS SET FORTY BY THE FLORIDA EM(J"Oj:
- THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY
PROFESSION*L LAIiD SJJRVEYORS IN CHAPTER 61G1•/�,• •
- THE PURPOSE OF THIS SURVEY IS FOR USE IN OBTAINING TITLE INSURANCE AND FINANCING. AND SHOULD NOT BE
FLORIDA ADMINISfRATN'E CODE OURSUANT TO 472.027, •
USED FOR CONSTRUCTION PURPOSES.
FLORIDA STATUTES. • • • • • •
- EXAMINATIONS OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY,
• • • • • • • • • • •
AFFECTING THE PROPERTY, THIS SURVEY IS SUBJECT TO DEDICATIONS, LIMITATIONS, RESTRICTIONS, RESERVATIONS
OR EASEMENTS OF RECORD, AND LEGAL DESCRIPTIONS PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY.
BOUNDARY SURVEY MEANS A DRAWING AND / OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK PERFORMED IN
•
•••• •
• • • •
- THE FIELD, COULD BE DRAWN AT A SHOWN SCALE AND I OR NOT TO SCALE.
• AG
EASEMENTS AS SHOWN ARE PER PLAT BOOK. UNLESS OTHERWISE SHOWN
• • • : A
BY. (lh'W J • • •
- THE TERM "ENCROACHMENT' MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS
EORGE IBARRA (6FlTE�€ ILD W�hK)
- ARCHITECTS SHALL VERIFY ZONING REGULATIONS, RESTRICTIONS AND SETBACKS. AND THEY WILL BE RESPONSIBLE
• • • • • • • • • • • • •
- FOR SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR APPROVAL FOR AUTHORIZATION TO
• • • • • • •
AUTHORITIES IN NEW CONSTRUCTIONS, UNLESS OTHERWISE NOTED THIS FIRM HAS NOT ATTEMPTED TO LOCATE
• • • •
PROFESSION �L�+ ND SURVEYOR NO. 2534
FOOTING AND/OR FOUNDATIONS.
STATE OF FL�R1 4(041D COPIES OFTHIS SURVEY WILL •
FENCE OWNERSHIP NOT DETERMINED.
BEAR THE EMBOSSED &EAL OF TjiE ATTESTING LANA • •
- THIS PLAN OF SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED.
•
SURVEYOR). • • • • • •
- HEREON, THE CERTIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY.
• • • •
- THE SURVEYOR MAKES NO GUARANTEES AS TO THE ACCURACY OF THE INFORMATION BELOW. THE LOCAL F. E. M.A.
• • • • • • •
- AGENT SHOULD BE CONTACTED FOR VERIFICATION. THE FNIP FLOOD MAPS HAVE DESIGNATED THE HEREIN DESCRIBED
REVISED ON. • • • • • • •
LAND TO BE SITUATED IN ZONE, X COMMUNITY/PANEL/SUFFIX: 120652 0302 L DATE OF FIRM: 09111/2009
BASE FLOOD ELEVATION: N/A.
• • • •
REVISED ON:
CERTIFIED TO: LISETTE JACOBO N
GARDEN TITLE CORP v��e
FIRST AMERICAN TITLE INSURANCE COMPANYqP
CORNERSTONE HOME LENDING, INC.ITS SUCCESSORS AND/OR ASSIGNS,TP N. I 1,11A
t'
ft
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
PERMIT #: 13 -SC -1 917745
APPLICATION # : AP 1393617
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PRI 199539
REPAIR
CONSTRUCTION PERMIT FOR: OSTDS Repair MWA14)ADE COUNTY HEALTH DEpARTW&R41.
APPLICANT: (provident Funding Associates LP)
PROPERTY ADDRESS: 165 NW 96 St Miami, FL 33150
LOT: 13
BLOCK: 3 SUBDIVISION: BonmarPk
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 11-3101-025-0130 [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 [ 900 ] GALLONS / GPD New Septic Tank I CAPACITY
CONTRACTOR... SOIL BORING
A [ O ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY (MAXIMUM CAPACITY aANf#I� '31NK3.1PF4,$, SU �p �r'rn A s��t bori:
K ( ] GALLONS DOSING TANK CAPACITY [ ] GALLONS @ ( jatS$B h58Rd24tFfi�33 excAv to
N
D ( 150 ] SQUARE FEET
R [ 0 ] SQUARE FEET
A TYPE SYSTEM: [X]
I CONFIGURATION: [X]
N
inspochon, prior to Firal A `" . t •e Ume of Fr
witness th0 �;t bo R�rovat, the ,FOOH inspector sh
New Drainfield Trench Con SYSTEM S4e evaluadan suo m d. a�n °ar` C `"(a, vs to m.e o� 'n
it then^4. /1 reins.,oc!i0n lee w h Ea a3sessi
SYSTEM ��'3.^t0! �:- nC::1::i� ' t
STANDARD [ ] FILLED [ ] MOUND [ ]
TRENCH [ ] BED [ ]
F LOCATION OF BENCHMARK: FFE 11.2
I ELEVATION OF PROPOSED SYSTEM SITE [ 12.00][ INCHES FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 47.00][ INCHES FT I ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D F
O
T
H
E
R
ILL XZWulRr:U: L U.UU J INCHES EXCAVATION REQUIRED: L 37.VV I 1VUKZ5
1: Install a 900 gal., septic tank with an approved filter
2.- The licensed contractor installing the system is responsible for installing the minimum category of tank in accordapqj
with s. 64E -6.013(3)(f) FAC. '
• • •••• ••••••
3.- Install 150 sf. of drainfield in ...TRENCH... configuration./'
4: Invert elevation and Bottom of drainfield to be no less than 7.78'& 7.28' NGVD respectively • • • • • • . • . • • • • : •
THIS PERMIT IS NOT FOR ANY ADDITIONS. • • • • • • •
The system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for atom gtimate;Mow pf •
•••••• • ••• •••••
SPECIFICATIONS BY: A Super Septic TITLE: • • • • •
•• •• •• • ••••••
APPROVED BY: 4-t'- VT— ` TITLE: Environmental Specialist II • • • Dade - Cm
Erick Perera • • • • • •
DATE ISSUED: 01/23/2019 EXPIRdION NATE: ' 04/23/1$ • i
DH 4016, 08/09 (Obsoletes all previous editions which may not be used) '.:•••
Ineoroorated: 64E-6.003. FAC Page 1 of 3
v 1.1.4 AP1393617 SE1149307
1
P
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR CONSTRUCTION PERMIT
Permit Application Number,
---------------------------PART II - SITEPLAN--------------------------
NEW OWNERS, PROPERTY UNINHABITED FOR A YEAR, NO WATER CONSUMPTION O TA NABLE....... • • • •; •
Site Plan submitted •
....•.CON'1'�iAZ"�YOR 0.00••
Plan Approved Not Approved • • •.l0 1-16-19
•
......
By ''�"` Y • Coonty He -alta flepartM 0.
0.000• •.•• .....
• . . •
.. .. .. . ......
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEP•AP.T•MENT
•
•
. . . . ......
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-0.001, FAC• • :00000 Page•2 of 4 •
(Stock Number: 5744-002-4015-6) • • • • 0 • • • •