PW-19-213Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
�{�U UUUin(
Issue Date: 02/01/2019
Parcel Number
1061 NE 91ST TER, Miami Shores, FL 33138 1132050010070
Contacts
Permit NO.: PW-01-19-213
Permit Type: Public Works
Work Classification: Public Works
Permit Status: Approved
Expiration: 07/29/2019
RYAN & WHITNEY ROMANCHUK Owner TECO PEOPLES GAS SYSTEM Contractor
1061 NE 91 TER, MIAMI SHORES, FL 33138 JESUS VEGA
15779 West Dixie Hwy, North Miami Beach, FL 33162
Business:
305957385777247
Other:3059701783
Description: TO INSTALL A NEW GAS SERVICE LINE (3/4" Valuation: $ 1,000.00 Inspection Requests:
PLASTIC) BY DIRECTIONAL BORE 305-762-4949
TotalSq Feet: 6.00
Fees
Amount
Education Surcharge (Manual)
$0.20
Permit Fee (Manual)
$100.00
Scanning Fee
$3.00
Technology Fee (Manual)
$0.80
Total:
$104.00
Payments
Date Paid Amt Paid
Total Fees
$104.00
Check # 3287
02/01/2019 $104.00
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: Ijzniii
y that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction a ng.Futhefmore, I authorize the above named cAtractor to do the work stated.
February 01, 2019 Page 2 of 2
\`V
RECEIVED
-, ';�'\ Miami Shores Village
" v Public Works Department JAN 3 0 2019
(305)795-2210 y
Public works forms are available from the building department, 10050 NE 2"d Ave., Miami Shores, FL 3313Cj
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
Permit#:1�(K P - 2-I `2
Name of Applicant (if utility see below): TECO PEOPLES GAS
Owner off the following described property:
Legal Description: Lot 8 Block 1 Subdivision WATERSEDGE
Folio #; 11-3205-001-0070
Address: 1061 NE 91ST TER.
UTILITY NAME: TECO PEOPLES GAS
Qualifier/Authorized Agent: JESUS VEGA
Address: 5101 NW 21 AVE.
City: FT. LAUDERDALE State: FL Zip: 33309
Telephone: 954-453-0806 Email: MCABRERA@TECOENERGY.COM
State Certification or Registration #: E1608 Certificate of Competency #
CONTRACTOR NAME:
Qualifier/Authorized Agent:
Address:
City: State: ZIP: _
Telephone: Email:
State Certification or Registration #: Certificate of Competency #:
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of
way: TO INSTALL A NEW GAS SERVICE LINE (3/4" PLASTIC) BY DIRECTIONAL BORE
Type of Work: ❑ Paving ❑■ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
Citv:
Telephone:
Registration #:
State:
Email:
ZIP:
Value of Work for this Permit: $1000 Square/Lineal Footage of Work: 6 LINEAL
*****Fees*****
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $ �Z_;3
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 Authorized Agent
The foregoing instrument was acknowledged before
me this day of 20 by
who
Signature 39t�
Company/Util Agent
The foregoing instrument was acknowledged before
me this —7-9 day of c— 20 19 , by
y.t .*, c g a who
is personally known to me or who has produced is personally knme or who has produced
as as
identification. identification.
NOTARY PUBLIC: NOTARY PUBLI
Sign: Sign:
Print: Print:
SEAL: SEAL:
HUBERTNUNEZ
' MY COMMISSION # GG 104234
�*WIRES: September 11.2021
_LknarWaF�
APPROVED BY: \ Publi orKS , IrEe or, or Uesignee
2017-04-15
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. . ... . . . ...
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. . . . . . . . . .
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. . .. . . . .. . .
. . . . . . . . . . .
. ... . . ... ..
• • • • • • • • • • •
• • + • • W,*k Arcs • •
400' 1 200'
ROAD
WORK
AHEAD
2001
J
� C
400' sa
zoo 200'
ROAD Nore Than
WORK 20d
AHEAD
200' I v 40a I v
J 0
ROAD
WORK
AHEAD
20V 4001
.0 ) to
a
SYMBOLS
GENERAL NOTES
®
Work Area
7. Work operations shall be confined to one travel lane, leaving
5. The FLAGGER legend sign may be substituted for the symbol sign.
the opposing travel lane open to traffic.
■
Channelizing Device (See Index 102-600)
6. The maximum spacing between devices shall be no greater than 25.'
2. When vehicles in a parking zone block the line of sigh[ to TCZ
signs or when TCZ signs encroach on a normal pedestrian
7. For general TCZ requirements and additional information, refer to
Work Zone Sign
walkway, the signs shall be post mounted and located in
Index 102-600.
accordance with Index 700-101.
[]�
Flagger
R. The two channelizing devices directly in front and directly at the
3. If work area is confined to an outside auxiliary lane, the work
end of the work area may be omitted provided vehicles in the work
c=�-
Lane Identification + Direction of Traffic
area shall be barricaded and the FLAGGER signs replaced by
area have high -intensity rotating, flashing, oscillating, or strobe
ROAD WORK AHEAD signs. Flaggers are not required.
lights operating.
4. Flaggers shall be in sight of each other or in direct
9. Use Temporary Raised Rumble Strips in accordance with Index
communication at all times.
102-603. Placement of Rumble Strips and additional signs should
begin at FLAGGER sign location.
It
CONDITIONS
WHERE ANY VEHICLE, EQUIPMENT, WORKERS
OR THEIR ACTIVITIES ENCROACH ON THE
PAVEMENT REQUIRING THE CLOSURE OF ONE
TRAFFIC LANE, FOR WORK AREAS LESS THAN
200' DOWNSTREAM FROM AN INTERSECTION
FOR A PERIOD OF MORE THAN 60 MINUTES.
CONDITIONS
WHERE ANY VEHICLE, EQUIPMENT, WORKERS
OR THEIR ACTIVITIES ENCROACH ON THE
PAVEMENT REQUIRING THE CLOSURE OF ONE
TRAFFIC LANE, FOR WORK AREAS 200' OR
MORE DOWNSTREAM FROM AN INTERSECTION
FOR A PERIOD OF MORE THAN 60 MINUTES,
DURATION NOTES
7. ROAD WORK AHEAD sign may be omitted if all of the following
conditions are met:
a. Work operations are 60 minutes or less.
b. Speed is 45 mph or less.
c. No sight obstructions to vehicles approaching the work area for
a distance of 600 feet.
d. Vehicles in the work area have high -intensity, rotating,
flashing, oscillating. or strobe lights operating.
e. Volume and complexity of the roadway has been considered.
LAST 0 "... Fy 2019-20 INDEX SHEET
REv,sloN ppp TWO-LANE, TWO-WAY, WORK NEAR INTERSECTION
11101117 W �- STANDARD PLANS 102-605 ] of 1
a;
t ---______ NE92ND ST
g 0 2L10 1,12d tf"3) 11 ) �� t-:r
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LOCATION MAP �N.T.S.�
GENERAL NOTES
1. REPLACED BASE MATERIAL OVER DITCH SHALL BE TWICE THE
THICKNESS OF THE BASE, MIN. 8" AND MAX. 18-
2. BASE MATERIAL SHALL BE PLACED IN 6- MAX. (LOOSE MEASUREMENT)
LAYER AND EACH LAYER THOROUGHLY ROLLED OR TAMPED TO 98X OF
MAX. DENSITY PER AASHTO T-180
3. ASPHALT CONCRETE PAVEMENT JOINTS SHALL BE MECHANICALLY SAWED
4. SURFACE MATERIAL SHALL BE CONSISTENT NTH SURROUNDING SURFACE
MATERIAL (1.5- MIN. THICKNESS)
5. BASE MATERIAL SHALL HAVE A MIN. LBR. OF 100 AND A MIN. CARBONATE
CONTENT OF 70X (60X FOR LOCAL STREETS)
6. CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES
sees
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.sees.
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eSe es e o
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e
•eesote
eeeS�sees
eseMAIN*Soso•cs•
• ••secs
AI
•: o e • e. SpD RES7,ORP710N DEt RESTORATION OF ROAD CUT L• •
scug NOT mscA1F sees FOR UTILITY CROSSING
N
W E
S
SCALE:1'=20'
LEGEND
CENTER LINE
M MONUMENT LINE
R/W RIGHT OF WAY
P/L PROPERTY LINE
E.O.P. EDGE OF PAVEMENT
T. T. TAPPING TEE
E.F.V. EXCESS FLOW VALVE
SVC. SERVICE LINE
PE PLASTIC
STM. SEW. STORM SEWER
ALL EXISTING UTILITIES SHOWN ON
THESE PLANS ARE TO BE
CONSIDERED APPROXIMATE do
SHOULD BE VERIFIED BY THE
CONTRACTOR PRIOR TO THE
START OF WORK OPERATIONS.
r
50'
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12
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MIN.
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2" C.S.
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8
1
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8
PusTic
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DIREC AL BORED
I
4
4
PROFILE CROSSING NE 91st. TERRACE SCALE: (V) 1:5' (H) NTS.
1060
a
F.I.P. 112' I t
3.46'
1 REC— 4 ED
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a6
1053
PROP. GAS
RISER I
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NIPROP.3/4" PLASTIC '
GAS SVC. TO BE 4
DIRECTIONAL BORED
1 .35 ,;
TIE IN SVC. T
GAS MAIN 54'
INI T T. TIE. F. V.
B. C 1
F,I.P. 112"
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x � x =-4— x x—rF4,..
II ,
I o ONE STORY ,� I
111.0' `` 3 N RESIDENCE 6
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11.30'
18.00' g TILE
TILE + i
o
to
3' 4.45� w
AC�CL
n .' 0.56' c�c
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/ ONE STORY
/ RESIDENCE
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COLU
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50.00' (R&M)
EXIST. 2" C.S.
MAIN 1-3
F.I.P. 1/2"
SIDEWALK s' - T: T ems' csw
6 0 1 PARKWAY
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da ............. ........... A....�A . . a ........ ° e
50' :Q:. ... . a
44' W '
B a d a a ° NE. a 1ST 'TERRACE ° a :a::: a
`P 4 (BAY
RIDGE AVFNIJE BY PLAIT) °
o l , NIA I
A
PARKWAY
SIDEWALK
Isesses �°' °'
S R/W >� 1050 1070 MMT NO.: 1
Drawing File: G.\Documents\MIAMI SHORES\1061 NE 91 ST TER MIAMI SHORES FL 33138\1061 NE 91 ST TER MIAMI SHORES .dwg 01/23/2019