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DS-19-2525Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Permit NO.: DS-10-19-2525 Permit Type: Driveways/Sidewalks/Slabs Work Classification: Addition/Alteration Permit Status: Approved Issue Date: 01/03/2020 Expiration: 07/01/2020 Parcel Number 18 NE 106TH ST, Miami Shores, FL 33138 1121360060070 :ontacts MARILENE SCHOFIELD Owner ROSS SERVICES Contractor 18 NE 106 ST, MIAMI SHORES, 33138 BARRY S GRIEPER 5325 NW 109 LN, CORAL SPRINGS, FL 33076 Business: 9542278944 rossservices713@gmail.com Inspection Description: INSTALL APPROX.800 SQ FT PAVERS Valuation: $ 10,700.00 Inspection Requests: 4949 DRIVEWAY/WALKWAY /SWALE TotalSq Feet: 800.00 Fees Amount Application Fee - Other $50.00 CCF $6.60 Concrete/asphalt/pavers, slabs, dways, $75.00 swalks DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $2.20 Planning and Zoning Review Fee $35.00 Scanning Fee $9.00 Technology Fee $3.13 Total: $184.93 Building Department Copy Payments Date Paid Amt Paid Total Fees $184.93 Cash 10/24/2019 $50.00 Cash 01/03/2020 $134.93 Amount Due: $0.00 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 nam ra for to he wor�stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date January 03, 2020 Page 2 of 2 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 BUILDING PERMIT APPLICATION QBUILDING ❑ ELECTRIC ❑ ROOFING N f 24 2019 FBC 201`1' I° Master Permit No.'DS— 1 C) _ IC1 — a5015 Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 18 NE 106 St p City: Miami Shores County: Miami Dade Zia: 3,5153 Folio/Parcel#:1121360060070 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Marilene Schofield Phone#: 3056130092 Address:18 NE 106 St City: Miami Shores state: FL Zip: 33138 Tenant/Lessee Name: Email: ne#: CONTRACTOR: Company Name: Ross Services Phone#: 9542278944 Address: 4620 W Commercial Blvd, #2 City: Tamarac State: FL Zip: 33319 Qualifier Name: S Barry Grieper Phone#: 9542278944 State Certification or Registration M CGC1507522 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Value of Work for this Permit: $10700 Square/Linear Footage of Work: 800 Type of Work: ❑ Addition ❑ Alteration ❑■ New ❑ Repair/Replace Description of Work: Install approx. 800 sq ft pavers driveway/walkway/swale Specify color of color thru tile: Submittal Fee $ _050 1?0;'x Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ Zip: ❑ Demolition CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ Sob - Cr3 TOTAL FEE NOW DUE $ _::� 4. / (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 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 / V � � Signature OWNER or AGENT C TRACTOR Ir The foregoing instrument was acknowledged before me this 19 day of August 12019 , by Marilene Schofield , who is personally known to me or who has produced FL DL identification and who did take an oath. NOTARY Sign: Print: Sandra lsuoltaN Seal: ILOL-£0-4o 8811dx3 AIN uo cs wwoo ep!6 li ;o e a S - o!IQnd AieloN t/a3Ala 'i V)JON`dS APPROVED BY The foregoing instrument was acknowledged before me this 19 day of August 20 19 , by S Barry Grieper , who is personally known to as me or who has produced identification and who did take an oath. NOTARY PUB as Sign: Print: Sandraf RIV SANDRA L RIVERA otary flublic a e o onda •= Commission A GG 71319 Seal: i.�z My Comm. Expires 04-03-2021 Bonded Through National Notary Association Plans Examiner ceJ� 3 Zoning Structural Review Clerk (Revised02/24/2014) 8/19/2019 Property Search Application - Miami -Dade County OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-2136-006-0070 Property Address: 18 NE 106 ST Miami Shores, FL 33138-2035 Owner JOHN CHRISTOPHER SCHOFIELD MARILENE SCHOFIELD Mailing Address 18 NE 106 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1000 SGL FAMILY - 2101-2300 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 2/2/0 Floors 1 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 1,220 Sq.Ft Lot Size 9,225 Sq.Ft Year Built Multiple (See Building Info.) Assessment Information Year 2019 2018 2017 Land Value $230,638 $230,638 $230,638 Building Value $68,076 $68,076 $68,076 XF Value $36,056 $36,483 $36,912 Market Value $334,770 $335,197 $335,626 Assessed Value 1 $265,359 $260,4121 $255,056 Benefits Information Benefit Type 2019 2018 2017 Save Our Homes Cap Assessment Reduction $69,411 $74,785 $80,570 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead I Exemption $25,000 $25,000 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description DUNNINGS MIAMI SHORES EXT NO 2 PB 41-78 LOT 7 BLK 202 LOT SIZE 75.000 X 123 OR 15232-2787 1091 1 Generated On : 8/19/2019 Taxable Value Information 2019 2018 2017 County Exemption Value $50,000 $50,000 $50,000 Taxable Value 1 $215,359 $210,412 $205,056 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value 1 $240,359 $235,4121 $230,056 City Exemption Value $50,000 $50,000 $50,000 Taxable Value 1 $215,359 $210,412 $205,056 Regional Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value 1 $215,359 $210,412 $205,056 Sales Information Previous Sale Price OR Book -Page Qualification Description 05/22/2013 $318,500 28660-2705 Qual by exam of deed 10/01/1991 $69,000 15232-2787 Sales which are qualified The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp Version Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: /COPY A. OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. ✓ COPY OF LIABILITY INSURANCE* D. —�7 COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. ............................................................................................ BUSINESS NAME: ©S S '5tmv t BUSINESS ADDRESS: �l(v20 W C°©rnrn ��uti CYTY 4�Nlt�'- STATE ��- ZIP 3331q BUSINESS PHONE: 851 Lt ) 2 21 $q U FAX NUMBER (~I �a 2�3 55(.c2 CELL PHONE (�5� ) 2 y CAI QUALIFIER'S NAME: G�i QUALIFIER'S LIC NUMBER: CG C 15O'T5 2Z DBPR - GRIEPER, S BARRY; Doing Business As: ROSS SERVICES, Certified General... Page 1 of 1 11:16:47 AM 10/24/2019 Licensee Details Licensee Information Name: GRIEPER, S BARRY (Primary Name) ROSS SERVICES (DBA Name) Main Address: 4620 W COMMERCIAL BLVD TAMARAC Florida 33319 County: BROWARD License Mailing: License Location: 4620 W COMMERCIAL BLVD, 2 TAMARAC FL 33319 County: BROWARD License Information License Type: Certified General Contractor Rank: Cert General License Number: CGC1507522 Status: Current,Active Licensure Date: 07/21/2004 Expires: 08/31/2020 Special Qualifications Qualification Effective Construction Business 07/21/2004 Alternate Names View Related License Information View License Complaint 2601 Blair Stone Road, Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer. Coovriaht 2007-2010 State of Florida. Privacy Statement Under Florida law, email addresses are public records. if you do not want your email address released in response to a public -records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395, *Pursuant to Section 455.275(i), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. F-lowever email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. https://www.myfloridalicense.com/LicenseDetail.asp?SID=&id=C8A57E511 BF36B9F59... 10/24/2019 t I CERTIFICATE OF LIABILITY INSU MINCE 1 OTM7=9 THIS CERTF"TE ISSUED AS Al MATTER OF ONWINATION ONLY AND CONFERS NO ROM UPON THE CERTIFICATE HOLDER. THIS CERfFlCATE DOES AFFMNATMELY OR NEGATIVELY AMEND EXTEND OR ALTER vm COVERAGE AFFORDED BY THE POLICIES BELOW. THIS OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BEMEEN THE ISSUING INSURER AUTHORIZED REPRESENTATWIVEP:RiODUCER, AND THE CERTIFICATE HOLDER. 11111131ORTANT, Uthe"lic -I, bokI6rIsanADDITIONAL NSUREDLisa ~m) mustbeendonmKI. WSUBROGATION IS WAIVED, subject to the leave and 01#0 certain policies may require an endwmnenL A statmindon this cerillicale does not cwffer rights W the sxrbficala holds In of such PRDDUCERCONT REEL WSURANCE AGEli Pf E4MUUL' DIEW COVERALL RM ANCE AnnVAMr, BUND wocm �aoow. AnA" BLVD Nsul"MAI'mm" E I I te -1 �il- � 7 1=7 zK SERVICES imc m Ross WRAM &%i). 92 C0VF"0Fft I fN2wn&wlj&lw ulmmmam. I 2birtmolo.0 " 2a --- T " THIS IS TO CERTIFY THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED To THI INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED- rANDiNra ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT oROTHER DOCUMENT WITH RESPECT To WHICH THIS MAY CERTIFICATE MAY BE OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES 134SCRISM HEREIN IS SUBJECT TO ALL THE TERMS, BE N1 nIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN B-PPAJDCLAIMS. EXCLUSIONS AND C am L'm OF046AWM =a mm P01MY EFF UNITS A x comm"*1 LuAlom CLAIMS40ME X OCCUR RFLO20006M 7116019 TRW= EACH OCCURF59CE SlAomm DAUMM TO REWED NED EW (Am . s 50.000 PERSONAL & AM WJURY 51 000 GM AGGREGATE Loso FLES PER: PRD- POLICY ❑ JECT LOC GENERAL AGGREGATE SZ090,000 PRODUCTS - COMPW AM SLM .000 AUTOMOINLE LWARHY ANVAUTO ALLOWNED SCHEDULED AUTOS AUTOS NON40VYNMPROPERTY HIRED AUTOS AV= COMBISED SlNGLE umrr BOmYlNAJRY(Pwpwwn) s BODILY 011AW (P- a-kwn) s ONDAAGE $ UMBRELLA LIAR EXCESS LVA OCCUR CLANISMADtAGGREGATE EACH OCCURRENCE om Va rr. Pq AND ENIMLAOVERS' YIN ANYBM 0FFKA3tNAEM3ER EXCL b #"" EJ QE NIA i PER rfF OT11- sxAm rtR F-L EAQf ACCIDENT $ ELL DISEASE - EA F I D9SEASE - POLICY LWT B BOND ORAW152 44=9 BOND LMITS $10000 OESCNPTIDN OF OPERATIONS LOCATIONS IVEFOCLES (ACORD InAdmonidnomkofto mWbe aeaAed GENER& CONTRACTOR wciwlm - S. mm tEm IS C0VM:D UNDER MURACNE POLICY. toAF4K.;t3J-A I ION UM SHOT S VILLAGE BOLDw DEFT SMULD AN = Y OF THE 460K WSCR101910 POLK5 BE CMMUM WFORE TOE: lowNE2*AVENUE TOE: J�Tmm DAkE THEREW, NOTE VILL BE DELIVERED Of Z+RDAmm VAM THIt POLICY PROWS10015. MOSHO"FL331311 ski AUTHOROSD REPRESD� Icom 01 ACORD CORPORATION. AN rights, reserved. ACORD 26 (20141M) The ACORD nano and logo are registevedirm of ACORD 0� ROSS SERV Financing ICES ' a Available 4620 W. Commercial Blvd., Suite # 2 Tamarac, FL 33319 Phone: 954.227.8944 • Fax: 754.223.5562 License #: CGC1507522 November 25, 2019 State of F7Lo fZ i b A County of 'b A D E Before me this day personally appeared 3 • "b9gA?, J C iF-PF-R who, being duly sworn, deposes and says: 14.1 That he or she will be the only person working on the project located at: 1� MJ- 106 5T MIRW SNORES, IEL 330 Id S. Barry Gr' - CGC1507 22 Qualifier Sworn to (or affirmed) and subscribed before me this 2 - day of IIIO VE M B E R , 20 1q by . 6Akku 621 PER Personally Known or Produced Identification Type of Identification Produced Sandra L. Rivera - Notary SANDRA L RIVERA Notary Public - State of fiorida Commission # GG 71319 My Comm. Expires 04-03-2021 Bonded Through National Notary ASSOC1600n Notice to Owner -Workers' Co Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 sation 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. III !. it• �• State of Florida County of Miami -Dade The foregoing was acknowledge before me this 2-57 day of 0 O VEM GE R , 20j. By MA(21 LEf) C 5C HO r i 6(_b who is personally known to me or ha roduced L_ as identification. Notary: SEAL: SANDRA L RIVERA Notary Public - State of Florida My Comm. Expires 04-03-202 Bonded Through STATE OF (FLORIDA) COUNTY OF (DADE) The undersigned Affiant, Miami Shores Village Building Department SURVEY AFFIDAVIT Marilen Schofield , does hereby attest that 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 (Property owner) The attached survey, performed by Alvarez, Aiguesvives & Associates Inc (Name of surveyor's company) For address: 18 NE 106 Street, Miami Shores, FL 33138 Performed on 5/1 /13 (date of survey) is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits. Further, Affia y e naught. Marilene Schofield Property Owner Sigature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this 19 day of August Affiant is personally known to me, X produced FL DL as identification. Revised on 5l22/2009/Revised on6/12M ,, i SANDRA RIVERA ., �. Notary Public -SS tate of Florida Comm°t + My Commis Expires 04 03- 021 Sondrrd Through ��� National Notary Association 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. Signature: Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this ( day of bECEM GE IZ , 20 19 By M A-21 _L-V) E 5C IAOF I E LD who is personally known to me or h produced F L (bas identification. v�,,,,.� SANDRA L RIVERA Notary Public • State of Florida '. , Commisslon if GG 71319 Notary- ;o �i My Comm. Expires 04-03-2021 ®onded Through SEAL: National Notary Association `D� ".0 Financing ®SS SE�CE°`� . Available RVS 4620 W. Commercial Blvd., Suite # 2 Tamarac, FL 33319 Phone: 954.227.8944 • Fax: 754.223.5562 License #: CGC1507522 December 16, 2019 State of 1I-0 2I C�A County of DAD E Before me this day personally appeared, S.'BA RR to G2I EPE2 who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: 1$ NE io6 5T M % AM 1 5N012ES FL 33132 S. Barry Grie er - CGC1507522 Qualifier Sworn to (or affirmed) and subscribed before me this 1 G day of D ECEM r3 E IrZ 20 lq by S , (3AIZR!A G21EPE2 Personally Known ✓ or Produced Identification Zy tification P oduced Sandra . -v a - Nota ublic ...... SANDRA L RIVERA Notary Public - State of Florida ,e Commission # GG 71319 >,'y;JE My Comm. Expires 04-03-2021 Bonded Through National Notary Association Brick Pavers • Travertine Marble • Eurotile • Stamped Concrete a Diamond Brite • Pool Coping • Pool Tiles --- AND SO MUCH MORE!!! Mlssloe: To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. `) -Marla HEALTH Vision: To be the Healthiest State in the Nation October 02, 2019 Sandra L Rivera 18 NE 106 Street Miami, FL 33136 RE: Contingency Letter Application Document No: AP1430345 Centrax Permit Number: 13-SC-1985245 OSTDS Number: 18NE106St Miami, FL 33136 Lot:7 Block:202 Subdivision: Ron DeSantis Governor Scott A. Rivkees, MD State Surgeon General �('7�� ade Co�rty r Neal Dear Applicant: This will acknowledge receipt of an application dated 08/23/2019 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. NO OBJECTION NEW Drive Way Review on 10/2/2019 by Frantz Toussaint NO OBJECTION LETTER ISSUED FOR A NEW Drive Way INSTALLATION NO IMPACT OVER THE SEPTIC SYSTEM INSTALLATION From a review of your completed application, it has been determined that your existing system appears to meet the minimum standards of F.A.C. 64E-6 for the proposed use. It is approved for use with the plans submitted to this office. If this system should fail, causing an unsanitary condition to exist, steps must be taken to bring the system into compliance immediately. Department approval -of the 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 approval requires the applicant to modify the permit application. Such modification may result in this approval being made null and void. Issuance of this approval does not exempt the applicant from compliance with other Federal, State, or Local Permitting required for development of this property. If you have any questions on this matter, please call our office at (786) 315-2446. Sincerely, Frantz Toussaint, ENGINEERING SPECIALIST II Florida Department of Health www.FloridaHealth.gov in DADE COUNTY TWITTER:HealthyFLA 1725 NW 167 St, Opa Locka, FL 33056 FACEBOOK:FLDepartmentofHealth PHONE: (305) 623-3500 FAX: (305) 623-3645 1 YOUTUBE: fidoh LEGEND - n u, $ A- = Arc— ,, ASPH -Asphalt N O RTHrM I A1ll I AVE U E -> �- . < .s BM = Bench Mark dour - c BRG =Bearing CAN = Catch basin CB = Catch basin `a'2'9 4, CBS =Concrete Block Structure F.D.H. ® F.I.P. /2" BLOCK CORNER _ t v CH =Chord 1J ..� y„- 0 Chatta: Chattahoochee =Center Line P.1. p;r„ § CLF = Chain Link Fence No L. ( � � °' � 9 E L 0 T 8, BLOCK 202 �. :��` too a -a 8-a = fi s (M ; CL. =clear , oi`o NoI.D�/2" O' a ° €a CDONC.=Del Concrete 122.86 (P) 122.90 (M) 1m E $ 3 NORTH t il t/ iz o m, L ._ t 0 =Diameter C1 $go,6 m W `o V= 3 m v o E - ° ° DH =Drill Hole , ��/ HE ^ .'.'.,.' C . y m � $ ` ° w DME = Drainage &Maintenance o� 90'16'32" 7'x 1'1 F.D.H. 0o .. Cr. W � 9' m "", v d Easement Qi , .. .... c v $ c E.B. • = Electric Box �g,5' \ ,� . 39.30 �� , . ' 1' ' ' ' ' ' O aBi m y m b mb° Enc.. _ 9A16 tchment \ ° E E m e c �• • E F.F. = Finish Floor • • • • \� \ NOCID 2_..-o." ', ... ... NC -A�d 2 m ti D.. • F.H.•iF'•�Vii'drant •• ~ /J.3 u o Pm E^- av�m' � �• '• m `at FP Florida Power F.I aLight ' ° psIron ba 26.22F.I.N Foyd Iron Pip% �Q m94owE F.N! aewtl Nail ojke = Light Pole •••• •cu c 12.6' s• c y `' m : i •.i` M • •=Measured • • • • '1n n m n- c 4 ••• _ \ 16' .D r-..'I .',e /��.'.' c I$ 0= o m x5*16 •g c M. 'WVAIFence O O ' 1 L Fr.... v / ° e o �i m A `' n'co M.H. = Manhole • • ° • • • I—Z m • N �, 1.55 �" �+ a r E M =Monument Line ' • '.' ' S•' • i--r ..' 0 C m g MCk J ODarWment • . a • . • z ' O W 1.55� tD �.... .. c v c o, B•m I1 i� N/A - Not Applicable • Z o Y� Y ¢z°oi-°rmn¢:nFSVa N/9 =+Tail&Disc �••••� J O - NTS• 01f7ptto Scale \ 3 10.0, N V 3 y m O.U.L. = Overhead Utility Lines (PLAT) ^ j� I" Q n g A OIL = On Line 15 ALLEY I - � �: ' H o m o P = Plat PB = Plat Book 0 35.70' 24.90' to A o PC = Point of Curvature 35.9' 0 P.C.C. = Point of Compound 2.6' ( .... Curvature Ll w' o c PCP = Permanent Control Point 89'4328 �'? 9018'50" .'•'.. .'.'•' r g PG =Page F.D.H. = .. N o ; m P.I. = Point of Intersection CL. Q- UAi r1 — 37.5 .... .:..;: a t 1 'et o Q o a PL = Plante Line U WE o 122.81 '(P) 122. 0'(M) o F.I.P. 1/2" ! w c n € P.O.B. = Point of Beginning /7j a m ' P.O.C.= Point of Commencement Y No I.D. D ' J M. E Q P.P. =Power Pole LOT 6, BLOCK C 0,10' NORTH I { `4V r- w T�tt P.R.M.- Permanent Reference Monument NI m y a L m n P.R.C. = Point of Reverse c v a m ., Curvature No I.D. NOTES: J It i d { o o v PT =Point of Tangency -No Tatted easement in this lot Y ; uV ' ' ' - L R = Radius gya a m 3 R/R =Railroad -No visible encroachments. This property, described as. N x o m PSM =Professional Surveyor mma� er TION q Lot 7, Block 202, DUNNING'S MIAMI SHORES EXTENSION No. 2, o gt ato RM/ =Right of -Way OJ �'(� --' 1-�.SZS according to the Pla t o f c k 7 C z� m= g SwK =Sidewalk H@511h Miami -Dade County CERTIFIED TO: fi of the Publtc Recor �� � t , �a����GG cc p S� Section = Typical r P, c7 ro a o a (lYP) =Typical Well Program John Christopher Schofield and Marilene Sch field=� i i i - �-Si r=—� PUBLIC 11�IORKS REVIE m j E _ � o T =Tangent " a'T ila ^' `o c u o y -° >ti m U.E.= Utility Easement Q TotalBank, a Florida Banking Corporation — I�.Vfm N = m tv = = W.F. =Wood Fence - HUM- 0 W.P. Wood Pole ,�PPRAI* No : -i iY3 .1'—� BY �/� APPROVED t.t/� DATE m � r - C € E E v E Q its successors and/or assigns, ATIMA 81. Z �� 7 'THIS SURVEY DECLARATION IS MADE ON THE FIELD = i= m 8 5 ' - 'a n W.V. =Water Valve �@ Joseph R. Colletti, P.A. A e m, m e g 1 - �(� DATE INDICATED TO THE OWNER(S) LISTED. IT 13 NOT m m N 8 ` O1 ° c 2 . 0 4} = Spot — p p ty' 1 -A U r, a ... a v'm N v v m" c- DenotesS t Old Republic National Title Insurance Com an F +' — TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR iy a c i-- 5 00� 9 c o Elevations Taken SUBSEQUENT OWNERS.- o 18 N.E. 106th Street, Miami Shores, FL 33138 Z " "' m r 'Ch1r _;frlc Vv: fH All FADER 1L BOUNDARY SURVEY. I ' . I HEREBY CERTIFY: that this survey meets the Alvarez, Aiguesvives and Associates, Inc. Bearing, if any, shown based on N/A (reference) ; N/A r , �. N •,f HLt •_S A°ID P_Gu1 ATIC1+s minimum to dards It forth by the Surveyors, Mappers and Land Planners c uoro.ea•IN+swrir\u-sea-+a "c +oa sr.a.. s/x/:mo +x s:+x w mr L _ - - FLORID AR PROFES NAL SURVEYORS AND MAPPER n chapter5 Florida Administrative 5701 S.W. 107th Avenue #204, Miami, FL 33173 REVISIONS: FLOOD ZONE COMM. No. PANEL No. SUFFIX: ELEVATION NOTE: (IF APPLICABLE) " . Not valid unless Code, pu ant to Sect• 72.027 Florida Statutes. Phone 305.385.0385 Fax 305.385.0623 L.F.Elev.= N/A . (lowest habitable floor elevation). it bears the x 12os5o 0304 L signature and the L.B. No. 6867 / E-mail: Fastsurveys@aol.com Elevation shown hereon refer to N.G.V.D. 1929. original raised seal j F.I.R.M.DATE F.I.R.M.INDEX BASE ELEV. Lowest adjacent grade elevation= N/A R VIVES 05/03/13 Field Date SCale: Drawn b : Drw . No. of Florida licensed Y 9 i BM. # N/A Elev.= N/A Surveyor and PROFE SIO AL SURVEYOR AND , os / 1 / os o9 / 11 / 0s + N/A N.G.V.D. y 05/01 /13 1 - 20 ELF 13-19862 ___ Garage Elev.= N/A Erp.= N/A Mapper. MAPPER o. 4327. State of Florida.