PL-18-3282DIVISION OF
Environmental Health
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00 Miami -Dade County /pO�
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11805 SW �266thh Street • Miami, FL 33175 Q
Inspector
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9 Address 0STDS #
Comments:
Signature
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:10/30/2018
Location Address Parcel Number
299 NE 99 ST, Miami Shores, FL 33138-2434 1132060134580
Contacts
Permit No.: PL-10-1
Permit Type: Plumbing - Residential
work ciass4kation: Septic/Drainfield
Permit Status: Approved
Expiration: 04/23/2019
TREVOR & KRYSTLE HAGUE Owner TREVOR & KRYSTLE HAGUE Applicant
299 NE 99 ST, MIAMI SHORES, FL 33138 299 NE 99 ST, MIAMI SHORES, FL 33138
Other:3053934461 Other:3053934461
SOUTHERN SEPTIC AND LIFT STATION Contractor
CORP
ROBERTO RODRIGUEZ
12040 SW 118 ST, MIAMI, FL 33186
Business: 30S5988266
nests:
Inspection Requests:
Description: SEPTIC TANK AND DRAINFIELD INSTALLATION Valuation: $ 4,000.00 IIns ns 762 494
Total Scl Feet: 1,393.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$2.40
DBPR Fee
$2.10
DCA Fee
$2.00
Education Surcharge
$0.80
Notary Fee
$5.00
Permit Fee
$90.00
Scanning Fee
$3.00
Technology Fee
$3.50
Total:
$158.80
Payments Date Paid
Amt Paid
Total Fees
$158.80
Credit Card 10/25/2018
$50.00
Credit Card 10/30/2018
$108.80
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.
AF
that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
i Futhermore, I authorize the above named contractor to do the work stated.
Owner ',,,/ Applicant / Contractor / Agent
Date
October 30, 2018 Page 2 of 2
BUILDING
PERMIT APPLICATION
Miami Shores Village
(^ \J E D
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 T
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 2014
Master Permit No. RC18-98Q421
,r f�
Sub Permit No- v z
BUILDING ❑ ELECTRIC ❑ ROOFING
PLUMBING MECHANICAL []PUBLIC WORKS
JOB ADDRESS: 299 NE 99 STREET
F ] REVISION [:] EXTENSION ❑ RENEWAL
(� CHANGE OF ❑ CANCELLATION [] SHOP
CONTRACTOR DRAWINGS
City: Miami Shores rniintw Miami Dade Zip:
Folio/Parcel#:11-3206-013-4580 Is the Building Historically Designated: Yes NO X
Occupancy Type: SFR Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): TREVOR & KRYSTLE HAGUE Phone#:305-613-5978
299 NE 99 STREET
City: MIAMI SHORES State: FL Zip: 33138
Tenant/Lessee Name: N/A Phone#:
Email: KRYSBAR@AOL.COM
CONTRACTOR: Company Name: SOUTHERN SEPTIC Phone#: 305-598-8266
Address: 21051 SW 234 STREET
City: HOMESTEAD State: FL Zip: 33031
Qualifier Name: ROBERTO RODRIGUEZ Phone#: 786-236-0539
State Certification or Registration #: SR0021421 Certificate of Competency #:
DESIGNER: Architect/Engineer: N/A Phone#:
Address: City: State: — Zip:
Value of Work for this Permit: $ Q00 0• O o Square/Linear Footage of Work: ? S
Type of Work: ❑ Addition ❑ Alteration A New ❑ Repair/Replace ❑ Demolition
Description of Work: SEPTIC TANK AND DRAIN FIELD INSTALLATION
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Permit Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF
DBPR $
CO/Cc $
Notary $
Double Fee $
-TQg
Bond $L) ✓ 7��
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding Company's Name (if applicable) NIA
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable) NIA
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: 1 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.
natu
Signature �-�^ Si g
OWNER or AGENT
The foregoing instrument was acknowledged before me this The foregoing instrument �ias ackn !edged fore me this
day of d CA"D C— 20 i CC by day of 20 by
Q r k a y i vG who is personally known to 4&o:Kly k own to
me or who has produced as me or who has produced as
DrWG%G—
identification and who did take an oath. identification and who did take an oath.
2b o St <-) a �S - o L l as w
NOTARY PUBLIC:
Sign:
Print: c ►- s hr
NOTARY PUBLIC:
MY COMMISSION # GG 044602
EXPIRES: November 2, 2020
Seal:
Seal: 'FOF F�oP' Bonded Thru Notary Public Underwriters
n "••.,• CATHERIDDUFFIN; Notary PublicridaCammliSlo6a SY#!landed ilxar,gh Assn.
APPROVED BY
Print:
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
PERMIT
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Trevor & Kryste Hague
PROPERTY ADDRESS: 299 NE 99 St Miami, FL 33138
LOT: 22 23 BLOCK: 33 SUBDIVISION: Miami Shores Sec
PERMIT #: 13-SC-1855028
APPLICATION #: AP 1349800
DATE PAID:
FEE PAID-
RECEIPT #:
DOCUMENT #: PR1138636
PROPERTY ID #: 11-3206-013-4580 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[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 [ 1,050 ] GALLONS / GPD New Septic Tank CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY (MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D ( 667 ] SQUARE FEET New Drainfield Bed Conf. SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [x] BED [ ]
N
F LOCATION OF BENCHMARK: C/L NE 99 St/ 3 Ave 10.37
I ELEVATION OF PROPOSED SYSTEM SITE [ 2.88 ][ INCHES FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 32.88][ INCHES FT I ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 72.001 INCHES
O
T
H
E
R
1.- Install a 1050 gal. septic tank with an approved filter
2.- The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
with s. 64E-6.013(3)(f) FAC.
3.- Install 667 sf. of drainfield in ...BED... configuration.
4.- Install 42 " of slightly limited soil at the bottom of the drainfield.
5.- Invert elevation and Bottom of drainfield to be no less than 8.13 ' & 7.63 ' NGVD respectively
THIS PERMIT IS NOT FOR ANY ADDITIONS.
The system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of
SPECIFICATIONS BY: Teresa J Solomon
TITLE: Master Septic Tank Contractor
APPROVED BY: TITLE: Environmental Specialist II
Er3.ck Perera
DATE ISSUED: 08/07/2018
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
Dade CHD
EXPIRATION DATE: 02/07/2020
Page 1 of 3
v 1.1.4 AP1349800 SE1088698
DOCUMENT #: PR1138635
licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s.
8.013(3)(f), FAC.
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.