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PW-10-21-2773
\ \ \ \ ��,b/RZa I„' � 4� � � ��#'3�"� �'��`"��*����l f \ ��. �� ��° 11�iarr�i Shaar�s I�ilCag� �� �� � � � �: � ,...�`��� ..�, ���; � s. � �,�., N,�,� �'�+ � iaoso�E z a�� �� ����u ;���� � ���� MiamiShoresFL33138 x.. ..��>� � ���. ��;.: �., ��.:� ���� �������?���� ; �, .. ti., , � �� �... .. �e„ 3Q5-795-2204 � ��.� ` �, � t �� a., , ��"��`����� �����,,�.� �t � � � ��f2�t� ,.� �. ,:; , ' � '•` ;�����a��:��:�����:; EXpIC�tt�tt: �5fQ4f2l22 ,�,�. ,,,,.�. Locatietr�Address Pareel(Vumber j �4t 176.�7��.7��iTdl����.8[E���Sd F'L���?G4 d.d.7,i.V�id��V�3� " . . . . .. ..... .. . . . . ���a�"� . .. . . . . C9CtY3�tS 3 JAVAN THC3MPSC}N Auaner Ct�AR�iP10N CONCRETE ContracRor 30 NE 97 ST,MkAMf SNQRES,FL 331382331 1AIME BASIIIt� 202�4 NW NW 63 terr 1t}5, DORRL,FL 33178 i �usiness:305252�Q5S jaimechampiQn c�yahoo,eom Mobife:74640248Q2 Hame:3059784333 C3ther:7$64424�02 � � �� � _..___w_.�_�._....._..�._,��..._....._..�..............�,w...�._�_._._..._.�.�..._...,__._....,�.....�.._._....�.,._..._,.,....,.,_..,._...___.._.._...__.._....�,�,.....___,.._..._.,n .._..._._..�__....n.._,......�.._....n._....,.....:....._...,.�..�_....�_........_�r......_.,.,...n,..,.., Ins �ct�on R� uests � D�seripti�n:replace entrr�street sidewalk � Valuation: $ 3,5�0,�0 �� € � ��� ��� T�taE Sq Feet: 3�5.OQ ; �.....�. '� �� �< �..,..�. �:..... .,...,. _:�� �,,:�.� ��, ��� � � Fees �mour�t P�ymer�ts Date Paid Rmt F�id Education Surcharge $Q.80 Tata1 Fees $152.34 Publie Works Permit Fee 52Et0.OQ Credit Card 11j04f 2021 ��g�,3{} Scanning Fee $4.Q0 Technology Fee $2S0 Amount Dtte: �0.00 Tatal: $112.3� ul� Itl Cl� y In �onsideration �f the issuanc� to me of this permit, I agree ta perform the�rork cgivered hereunder in compliance with aII ordinances and regulation� p�rtaining theret� and ir� strict confarmity with the plans, drawings, statem�nts or �peci�ications submitted to th� p€ap�r authoritfe� af Miami St�oras ViElag�. In �ccepting this permit I assume re�pan�sbility for ail work dane by either myseif, my agent, servants, ar emple�yes. ( undee�t�nd that sapaeate permits�re required for EL�CTRICA�, P�UM�ING,M�CHARlICA�.WfNDf�WS,DQORS, ROOFING and SWIP�MING F'00�work. QWNEF2S AFFIDAVET: I certify that all the for�gaing informatian is accurate and that all wark will be don� in compliance w�ith all applicable laws regulating construetion ar�d zoning. Futhermore, I autharize the ab�ve narrted eonteaetor ta do the wark stated. ��€.9��� � C`��� � Authori�ed>ignature:Owrrer t Applicant! Contraetear f Agent Date Navember Q4,2d21 Pag�2 of 2 � � � � ��,.�,���... �������;�.,� . � ��." � � � �,�,,.� � 11�iami Shores Villa�� ,,.� � Public Works C}epartment �1"�'��.� {�0��7��-z2�o ����, . ��R n Publie warks f�rrt�s are available from th� building department, 100SQ NE 2"a Ave,, Miami S�iores�.��� �38 PU�LIC W(�RKS PERMIT APPLI�ATION Permit Type:W�rk in the Right-c�f-Way on Miami Shores Village crr Mismi-Dade Property Perm it#: ��"' �� �� �*�� �lam�e��Applecar�t �if utility see b�{ow). � �� �� ��`�.��� �wner off the followir��d�scribed property: Legal C�escriptior�: Lo� � .'�� Bf�ack � S�bdivi�ion��� � , "����..� ��`�. �� �� �olio#, �m.��-� �w�l� `� ����` ,4ddress: � �! � �� °�� ��t��� E�TIL(T`(�IA[VIE: Qu�lifierjAuthoriz�d Agent: �ddress: C�ty; State; ZIP: T�lephc�n�: Email: State Certificat6c�n or Registration#: �ertificate�f Cor�pe�er�cy# CQNTRACTQR �I�ME: i�.� �.����'�� Qual�fier/�kuth�rized Ag�nt: �°�' � .l'�`� ���� ���� Address: ����� �� °`� "��� ,.�a��`I�� �`�1� City: �,� State: ZIP: „��7� T�[�phone. ,��-��,�'C�.,�� °� �mai(. � � ��� ��,������ ��� � State Certification ar Registratic�n#; �ertificat��a€Compet�r�cy#: � �� ��� ����� R�quest� perrr�ission tc� instal{ �descrika��rQrk, attach separat� pa�e if nec�ss�ry} in t�e �djoinir�� rigF�t a� w�y: °� ls � �'�i��`� , �;��� ,.��r ��° T�pe e�f Wcsrk; ❑ Pavin� �] Utility ° Side�alk [� EPectr;e [� Irriga�ic�n � Landscape [� An��r�n� � C�th�r: QESlC�f�ER: Architectf Err�ine�r: ,4cidr�ss: City: S�a�e: �IP: Teleph�an�; Err�ail: fte�istr�t��n�#: , t � �. �� �� � � � � � Va��ae �#Vilc�rk f�r tF�is P�err�it: �� � � � Squarejt�ir�ea) F�o���e.���?tle��l�: � �. ���' �� m � �� ����� ��*�� ��� ` � �< F�es , Permit Fee $ 2QC�.C7Q Nc�tary$ Tra�r�in�JEducatican $ 0.20 Teel�nealo�y Fe�$O.�Q Scanning $ Bond � (if required� Total Fee I�c��r E�u� $ � f ,� � ��� �c�ndir�� �c�mp�e�y's Name (if�pplicabl��: Bonc�ir��Corr�pa�y's Address: City: State: ZIP: Applicat€on i� her�by rr�ad��ca c��tain� pub(ie u,r�rks permit to do the work in the ri�ht of way and ir�st�llati"�r�s asiridic�t�d. 1 c��tifiy that r�c�work c�r installatic�n has commer�eed pric�r t��he issuanc� of a p�rrnit�nd that ail work wilE be perforrri�d te� rneet the sta�€dards€�f a!I law�, r�gulatian cc�nstructi�r� ir� this jurisdiction. I understand that sep�rate permi�s must be secured f�r �PPI.I��tN1�'S AFFI(���IT: I certify that all the fore��ing inf�rm�tion is accur��t� and tha� all wc�rk will be dor�e in cc�mpliar�ce with appi�cable laws regulatin�cor�structic�n ar�d specifiealPy constructian in the ri�ht-c�f-v,ray. "WARNING TO APPLI�ANT:YOUR FAILURE TO RE�QRD A NQTICE QF C�MMENCEMERIT MAY RESU�.T IN VQ�1R PAYING TWICE FOR IMPRQVE�IENTS Ta TNE RIGNT-Q�-WAY. IF YC�U INTER![�TQ �B�`AI'IV FIN��CCfUC�, CC}f�SULT WlTN YQUR LE�IDER OR t��! ATTClRNEY BEFQRE RECQRDING YC�UR R1C?Ti�E �F C�MMENCEMENT.,, �loti�e to Appiieant: As a e�r�ditic�rs tc�the issu�nce of a public we�rks permit with an estirr�at�d vaiue exce�dir��$2,St�E�,the applicant rnust promise in �oocf faith that a copy ot the notiee af c�mr�nencem�nt and cc�nstruc�ion It�n I�w br�chure v�rill be delivered to Che person whose property is s�bjee�to the at�aehmenfi. Also, a eertified copy e�f the recordeci notice ofi cc�mmencern�nt must be posted at th�job site fe�r the first inspecti�n which occ��s s�ven (7) days after tFre public works permit is issued. In the aE�sence of such posted natic�, tl�e irrspectiart wifl not b� apprc�ved and a reinsp�ction w' I I�e charg�d. �.� �,�-r"� � � t ��� ,� ���u�� Signature ��«� � ° ���� � �"�" �~ ����- Si�nature ,�° ---- ._ �� �PPlie��nt ar Authc�rized�gent Compa �YfUtility�gent The faregoing instr�ame�t was��kr�ow6ed��d bef�are 1'he foregoin�instrum� �ra. acknowledged k�efc�re me th�s�����ay q�f s� ,������� , 2E����s �� , �y me this '„� � day c�f , 20 ' , bY � � �� , �`� r�� � �� ����;� � who � � �, � who � is pers na(�y kr�e�wr��o rne o�who has p�ad�.�ed is p��sanalk kr�e�wr�to m�or v�h�a has pro��c�d � � ��� ��G �� � ,��.� �a� q� � '�' .�'�..,g �,. �s� �` �.�»� ��,'��`'' ���»• c3 S 'I � c�S �-- �de�tificat�z�n. �� �dentificatia�_ ��� ��, �lt�TA,RY PU�LIC: ��� '` � �OT�RY PU�LiC: �.... �M���� �r� .n� M � Sign: � � Sign: � � � � � -� � Print. ,�' �� ��"���° ��'�������'' Frint: � � � SEA�: ....� �.�.�. �,,;��.�sR,� �t�3��� ���� � ����n� SEL�NA�4R.�P�C�A � �: �fY� t��SStC�h!#�G 97t7Q5 � ;�� N� �7 '��` � �XPIRES=P��r�P�22�2Q�4 ��,.�� �S��t�f�, �"'•'�°&�`;°" Bonde6 Thru N�k�a�I�b#ic U�den#eit�rs .�>�+ �a�**���*����w�a����*��x*��*a�����***�*�:*�x�**��m��� APPR�VE� BY: ���� � a� '""" �'"` ��� , Publie Works C�irector, or [�esi�nee 201?-04-15 t��a� Miami Shor�s Villa�e 3��������������1���I���t�������f���������#�1� � Public Works �epartment C.�"$�i '������ �i.�a,��r�€����� (305}795-221Q ���' ��' ��b��.' �'a u��� � F��� '�,4, �� �:����R€�E;� 1�?=<:��,{�i_€?� ��� s_��;A �:� N€tFii��`r` �iJ�I1�p S�.E�ERk. �i� �QUFiT �'"'�"�� Public works farms are availabie i�I��i'�I-E���ia� C��4�l�T`tx F��n:�G,H �"�.���` from the buildin�departmer�t, 1CIQ50 NE 2"d Aue., Miami Shoees, FL 3313� CQVE�tRNT QF C�NSTRU�Ti��V WtT'HIl� �EGF!°T C?F W�Y Wh�reas, (hereby referred to as th�owner}-��"u � ` ��' Of the f�llawin�des�ribed pr� �rCy: �,;,,,� ��� Ce��! t3escriptian: l.tat � � Block S�bdivrsi�n �r � � FoCF�a#; ��� �'�� � ^`�� !.� Address:� � /t�� �� �� �'�`��� .S 1".�'"�,'.� / l� �.��'�� Requests perrr�issian to install (describe wark, at�aeh separate pa��ifi necessary)in the adjoiri�ng ri�ht of way: ��� � ����� �t��p � !(� C(JN5IDERATI�N of the approval of this permit k�y the village,the�wn�r agrees�s f�lle�ws; 1. To maintain and repair,when necessary,the abav�-mentianed item(s) inst�ll�d within the d�dicated right of way. If it becames necessary for Miami Shores Village c�r Miami-Dade Ccaunty to make repairs or maintain said items within th� public right of way including r�storatior�of the street by reasan of th��wner's failure to da sa, sueh axpense shall be paid by the Own�r or shall eonstitute a lien a�ainst the abe�v�d�scribed property until paid. 2. The awner does herby agree to indemnify and hold Miami Shores Village or Miami-Dade County harmless�rc�m any�nd all liability,which may ris�by virtue af permittin�the installation of these items within the public ri�ht of way. 3. The Owner does h�reby a�re�to remc�ve or rele�cate their f�cilities at their own expense, within 14 days` notice by the Village te�do so. Failure tca eamply waith this nc�tice wi(I result in the ViEl�ge causin�the item(s)tca b�remcsved and a lien being plac�d on the pe�p�rty andjc�r assessed a�ainst the Qwner for al(cc�sts incurred ia�the rerr�oval and dispc�sal of the item{s). 4. �"he a�ndersi�ned further a�re�s fih�t these cond€tions shall i�e deemed a eovenant rur�nin�with the land and shall rem�in in full fc�rc��nd effect�nd b.e bindin�on the undersignec[,their treirs and assi�ns untif sueh fiime as this c�bli�ati�n has been cancelled by an af�idavit filed in�he Public Reccards of Msami-[�ade County, Florid� by the l�ifEage Mana�er of(�i�mi Shores Vill��� (ar his fully autk�e�rized representative). �� �" Si�natue� �� �f{��� '�� ;�3wner or thor'szed Agent �; St�te of � �' Caur�ty of n �,�'� Th�foregoing inst�as acknawledged before me this�day of ��'�'�°,�� , 20��, by �,��,�;�1 '� "�'k`� � �°` who is persanalfy known to me or who has produeed ��� 4� ��������P���v���€� �� .. . ... ... . , ... ... , y as identifie�tian, � � , � � NOTARY PU��IC: � „t�ttik�. , ,�,. . � . . , � � r��`��;r�. . at� �. rx z t �1,�.,.,w. „ . .. __ ._.. ... . . t,l s � s mr � �. � � EF ,��. t �l�,tl: t ; _ �� ms„ } .� � �c.-k� , ._. r ,, t , � wt � . ... . .. . . ... . � , �. . <.. _, .. Print:��.���- �,���'�`_. SEAL• �t fi�,�� �����;�� ��� �� :';�„"�,``. � hEOR.. t�' ;�: �,= t�+t�� �ocuments�re re�orded at th��lerk of th� C�urts, '..�,*; ..., w, ES: 12. MI,AMI-�ADE COl1NTY RECARC}E�, COURTt�Qt1RSE EA1S'T, t ,���,,..�, , ';^�;, � .,.� 22 N.W. First Str�et, 2st Flovr, M�am�, FL 3322�. 20�.7-(}4-11 � < '� � �a . ... . . . .e: � •• ' t • ! • i f � i • ♦!• • � � �#(�} � , e `R $ !��'l��Eit� e^yp � � ffi � dn6{,�• !�X 3" tJ� . �� i`"i����. 4YiS.F.,�PaY4A��r�i � � • • , � ,,.� .._•.� � � ._.v.��a�� � �� � s• ry�n �t� . W �� �P e r p` ,d y! m ' e� . � ��~,.:s. �m:' f ����t���.�+�� * _ ! �ft t�TG+ C��p , fl � : . [#� • ` .au tv.6:.7J �� � � � �!P" � 8p� �t e t�ak t aa . . �� � � • • ! s • • �g ggp •O• • •!• • � �� 6't� �.� ��,^�� d.'StF m. � � � . 1t � � (� M r� L.�. � ! a� ( tI� � �e^at��# �f..R.. ... 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