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DS-07-20-423BUILDING PERMIT APPLICATION Miami Shores Village EN''ERED Building Department FEB 262020 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 Ays INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 2011 b�- Master Permit No. �)i—IJ-�--LAD ' 14 ®BUILDING ❑ ELECTRIC ❑ ROOFING F-IPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 1 4" r-C 100 Sub Permit No ❑ REVISION ❑ EXTENSION ❑RENEWAL CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS C itv: Miami Shores County: Miami Dade Zip: -3 31 ro 1 Folio/Parcel#: I i - -2 1 3c 009 - C%] I O Is the Building Historically Designated: Yes NO Occupancy Type: Sfe— Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Phone#: Address: 14q 1 o`2s -5 sr ec r City: m ; iyn. Sr=2 s State: -iL . Zip; 3 5 I c-, 1 Tenant/Lessee Name: r'1/A- Phone#: Email: I nfO �J i �.. ✓� �- CONTRACTOR: Company Name: -C7,c-r �S I0— --0cf:n Phone#: (`I61+);3'`T12C3 Address: (o5a t n. sri tc rzc-,ci -T "o City: -C¢c-e r— State: Qualifier Name: Il-);cf LC-UzC•k State Certification or Registration #: 4v'+s Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: Address: / City: — Stat Value of Work for this Permit: $ 68C2D • Oct Square/Linear Footage of Work: _ tip: '3-4C;--j-3 e:=Zip: p 3 Type of Work: ❑ Addition ❑ Alteration ❑x New ❑ Repair/Replace ❑ Demolition Description of Work: L124 c-, 1�i�•�C'¢— 'D23di= � Y %'� Specify color of , � color thru tile: Submittal Fee $ l qPermit Fee $ CCF $ CO/CC $ Scanning Fee $ Technology Fee Structural Reviews $ Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City SI Mortgage Lenders Name (if applicable) 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: 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. OWNER or AGENT The foregoing instrument was acknowledged before me this day of Fe-b(LCLiQ4 . 20 �' AD� by G(A SkfAb"t who is personally known to me or who has produced t- oe i rp'-- i 0 as identification and who did take an oath. Print: V Lows c Signatu CONTRACTOR The foregoing instrumen was acknowledged before me this tq dayofvta 20 2--b by "i C haej �--AC,121e- who is personally known to me or who has produced Iptcy-fo t fc> as Identification and who did take an oath. NOTARY P LIC: Sign: Seal: ` ..s+ hy. N9mry Puohe @chip. !N R".0 Seal ;�*y ;Notery _' R Louis ®Abrihl MAh1th@® ub io smre a Hondo My Commission 9C @aeibo ab el MachadoExpine i 1rF@ p®t€ mission pGG 279t50�f�j • iftpt of •tttittifttf ttigttttgit ptif if tiff tttt NRitf tfftititi APPROVED BY Plans Examiner Zon in Structural Review Clerk (Revised02/24/2014) @7-� OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-2136-009-0210 Property Address: 149 NE 108 ST Miami Shores, FL 33161-7037 Owner PAUL SKRABUT Mailing Address 149 NE 108 ST MIAMI SHORES, FL 33161-7037 PA Primary Zone 1000 SGL FAMILY - 2101-2300 SO Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY:1 UNIT Beds l Baths l Half 4/3/0 Floors 1 Living Units 1 Actual Area 3,202 Sq.Ft Living Area 2,944 Sq.Ft Adjusted Area 2,951 Sq.Ft Lot Size 9,300 Sq.Ft Year Built Multiple (See Building Info.) Assessment Information Year 20191 2018 2017 Land Value $232,690 $232,690 $232,690 Building Value $237,023 $238,077 $239,131 XF Value $1,960 $1,982 $2,004 Market Value $471,673 $472,749 $473,825 Assessed Value $357,411 $350,747 $343,533 Benefits Information Benefit Type 2019 2018 2017 Save Our Homes Cap Assessment Reduction $114,262 $122,002 $130,292 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead 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 5 PB 48-21 LOT 13 BLK 216 LOT SIZE 75.000 X 124 OR 18183-4417 0698 4 Generated On: 2/14/2020 Taxable Value Information 2019 2018 2017 County Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value 1 $307,411 $300,747 $293,533 School Board Exemption Value 1 $25,000 $25,000 $25,000 Taxable Value 1 $332.411 $325,7471 $318,533 city Exemption Value $50,000 $50,0001 $50,000 Taxable Value 1 $307,411 $300,747 $293.533 Regional Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value 1 $307,411 $300,747 $293,533 Sales Information OR Previous Price Book- Qualification Description Sale Page 04/01/2004 $357,000 260� Sales which are qualified 18183- Sales which are disqualified as a result of O6/01/1998 $0 4417 examination of the deed The Office of the Property Appraiser is continually ed'Nng and updating the tax roll. This webslte may not reflect the most currant information on record. The Property Appraiser and Miami -Dade County assumes no liability, sea full disclaimer and User Agreement at httplhw.miamidade.govfinfo/d'isclaimecasp Version: Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (3O5)756.8972 SURVEY AFFIDAVIT STATE OF (FLORIDA) COUNTY OF (DADE) The undersigned Affiant, P4LA5114-12^6n- does hereby attest that (Property owner) The attached survey, performed by &Ggeln L . min y sty -- wi do Lewv4 azv.� ycs<S (Name of surveyor's company) For address: 149 r-C 14=9 'Strz.ce`. m iim; '500129:5 tt . 331G'1 Performed on 81 � 03— (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. Furthe ant say I th n gh Property Owner Signature �.J Property Owner Print Name SWORN TO AND SUBSCRIBED before me this j / day of Affiant is _personally known to me, produced 0 as identification. Revised on 5rarzM1 Revised on M2,09 =)NotarVblic Stare of Floridaabriel Machadon"an GG 27gt5012is*022 DS-Qz--423 Illlailon: To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. (Owner) 149 NE 108 Street Miami, FL 33161 RE: Contingency Letter IV HEALTH Vlahm : To be the Healthiest State In the Nation March 13, 2020 Ron DeSantis Govemor Scott A. Rivkees, MD State Surgeon General Application Document No: AP1471931 • Centrax Permit Number. 13-SC-2045543 • • OSTDS Number: """ ••••�• 149SE108St Miami, FL33161 ����•� ' .... . .. Lot: Block: Subdivision: ...... .. •"�•• ..... ..:.•' Dear Applicant: "•"• """ This will acknowledge receipt of an application dated 03/06/2020 for a permit to use an existirrp • • ...... onsite sewage treatment and disposal system located on the above referenced prppea. • • ; ; • • • • Reviewed on 03/1312020. No objection for driveway replacement as per your Site Plan. NO BEDROOM ADDITION. NO FLOW INCREASE. 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) 315-2412. Sincerely, Jesus HemandezAcosta, Engineering Specialist II Florida Department of Health v .Floridaltealth.gov in DADE COUNTY TWITTER:HealthyFLA 1725 NW 167 St, Opa Looks, FL 33056 FACEBOOK:FLDepartmentofHealth PHONE: (305) 623-3500 FAX: (305) 623-3645 1 YOUTUBE: fidoh 1<L — u %S,tlU Pvµ-7 cl ve Pere rp. 8is�`4.1' •0119,s �,. 0. 00 G�.wa Fg2 � a c 2J.4i' C.3 z v s py m O n -4 ` m O r � m m N .w.i.' ...... Z M � ° a: � � � FiN•R.�e• roomy. �/_a,' :.. �. • O `7 ZJ•S.' • .• • ••• •. •.•• 9.7S IG3' jQ 7t 5'O. ...... f3 ace . qd a ytb 3. 32 5 PIPP. 7/PE K7 P¢ - � - M > PvN-7 h pipe ru 0. N REVIEW gUl1 DINS ACE rs.co3 r "� R.ov n +1 rz.6� PPPgO\/ED, 9s,v, a �1 d• 0: "a ZJ.AI• ..••. ... MIAMI SHORES VILLA E o ""' �••• Q PUBLIC WORKS REVIE ""• ti'•• '•:•• '�.:•' APPROVEDDAT s w •• ••••• Zo.A' .... w.7s' �SIC�w\k: ^S i' t -COUNTY-WIDE LAND SURVEYORS INC. LAND SURVEYORS PLANNERS P.O. BOX 823271 SOUTHiFLORIDA# FL. 33082 -3271 (305) 772-0766 W D Z. W a W Z NE. 108th STREET W Z W a C N W Z N LLCM ON SKETCH „w/ -70 sme O ° ° O O O LEGAL DESCRIPTION O O 00 0 a O O O 0 000 O O O O a O ° 0 Lot ° 0 0° 0 0 00 o 0 0 0 0 0 0 O 0 °.°0 0 o§a according 0 0 a 0 13 in Block 216 of DUNNING' S MIAMI SHORES EXTENSION N9 the plat thereof, as recorded in Plat Book 48 at Page 21 ofa ache Pppl, c Reprsl"I� of Miami -Dade County, Florida. O a 0000 00 a 0 0o Dave° 0 0 SURVEYORS NOTES: 0 0 0 0 0 0 a O a e 0 0 oeoooo O O O 0 0 O a s O a 0 0 0 e 0 0 0 0 0 0 0 O ° 1 ) . Legal description provided by client. 0 0 0 e o °. ° a . 000000 2) . Only record plat easements are shown. o a ° a ° ° a e a a a o 3). Right of way information obtained from record plat. 00 ° a 0000 o ° 4), In Federal Flood Zone X, Panel 0093 last revised 3-2-94. 0000 5). Benchmark used- Dade County BM # N-566. 6). Elevations are referenced to National Geodetic Vertical Datum 1929 Adjust- ment (NGVD29). Rfv /0-3-06 VPDA'?-- S Rev/ 3-ZZ- BOUNDARY_-& IMPROVEMENTS SURVEY qN.E. 108 St. Miami Shores, F1. suam Foy: - P A u r.. c K .R A a07 1 CERTIFICLATE NOTE: - NOT VALID UNLESS SEALED WITH AN EMBOSSED SURVEYORS SEAL." I HEREB\CECRCERTIFY -THAT THE. SURVEY REPRESENTED HEREON COMPLIES WITH THE MINIMUMCAL STANDARDS ADOPTED BY THE FLORIDA BOARD OF SURVEYORS AND RAPPERSPTER 61G 17-6, FLORIDA ADMINISTRATIVE CODE, PURSURANT TO SECTION7, Florida Statutes. REVISIONS BY DATE -- �p OridF.df��rvs ;try► 4-N-07 �OSEPH L. MARTIN Ara0 114 t/ t,ArtF,v� *�.�-, 9-I1-01 PROFESSIONAL LAND SURVEYOR .*4368 DRAWN SY SCALE GATE F.B./PG. J0810 ^ ,�� SUTE OF FLORIDA ��� j"-10 4-1-enZ�a�- l0 e 4� w L� T 1ij �L Z� $vy 1' �44if. FT =CLOC ,' Nwe61S S1nj-E Old Chicago 9845 N.W. 118tb Way. Medley, FL 33178 • Tel: 305-805-0000 • Fax: 305-805-0004 SPECIFICATIONS SF X PALLET: 101 PCS X PALLET: 336 PCS X SF: NIA F7 61mX 9m 614X 6w 61AX 4m Unique in shape, the Old Miami paver is designed and based on the Mewi0rleans c'gbblestondsleMs. The '"•;' • • • athazing'P1d Ykarld" look • • • enhances at7•pr0jact. ... • • (mica en.ju fw%la, el Old- • Miami eras dmehado y basado en el adoquin ae las caller dee• - - " •' A eva OrLebfls• Eq asomlMD • • • •epariencia del vk+jo munab• • • r Iza el encanlo de cualquier • •ProYeclo. , , ....:. Stack Bond Random PCS X PALLET 6X4 6X6 6X9- 112 EIO PCS X SF: 4X6=6 6X6=4 6X9=2M Salomon GE1VJ1 PAVER SYSTEMS, INC. aa+trnnumssff WIERLQRYoaao�v/•HCi LELACK CONSTRUCTION info(a?lelacic.cam CGC1514048 6574 N STATE RD 7 #220 - 954-263 7120 Coconut Creek, FL 33Q73 License and Insured Proposal #07201009 February 3r' , 2020 Paul Skrabut 149NE108ST MIAMI SHORES, FL 33161 leased to present this proposal to provide our contrasting services for the above We are p referenced project. Our services and fees will be as follow: Scope of work Double Brick pavers driveway and pathway) BRlE 9 DEMO AND REMOVAL THE EXISTING BRICK PAVERS, CONCRETE D DE o PROVIDE LABOR, BRICK PAVERS, BASE, SANDND COW OR TO BE CHOSE BY OWNER. � LELACK CONSTRUCTION TO PROVIDE BRICK E COMPACT AND PLACE FINAL SAND (POLYMERIC SAND) FOR GRADE AND a GRADE, INSTALLATION. 0 CLEAN UP AND REMOVAL OF LP CORM .� WORK. o PROVIDE ALL LABOR AND EQUIPMENT o ALL WORK AND SUPERVISION TO BE DONE BY EAGLE CONCRETE CITIES AND L' © LELACK CONSTRUCTION IS NOT RESPONSIBLE FOR ANY TYPE OF U LANDSCAPE RESTORATION. Driveway above -described base on a site visit will be $6 The total cost for the new Brick Pavers D 0 worifng days. Permit fee by owner. our estim ed co ' n time is apprc e Y $1,200 to replace sidewalk by the driveway { } Driveway sealer $750.00 This proposal is only valid for 3& daYs ment agreement: 30% deposit t0 be upon signedal ��, Pay 40% after escavati©n and ma� 30% after comPleoon L a�q-0 DATE 2 ".) P PA-M Thank ou four choosing Lelack Constructions We hope to work with Your project soon. Tha b Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to VWrler — vvorKerS- L.ompensavorl insurance tXemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Star. § 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: / _e< Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this I LII SEAL: day of e_1,2e,(y 20 Z ? who is personally known to me or has produced fication. =.bor cha27�an� LELACK CONSTRUCTION 6574 N STATF RD 7 #220 info(aAelack.com CGC1514048 Coconut Creek. FL 33073 License and Insured 954-263-7120 February 25, 2020 State of Florida County of Miami Dade Before me this day personally appeared Michael Lelack who, being duly sworn, deposes and says: That he will be the only person working on the project located at: Skrabut Residence 149 NE 108 Street Miami Shores, FL 33161 Contractor Signature Sworn to (or affirmed) and subscribed before me this 25th day of February 2020 by Michael Lelack. Personally Known Or Produced Identification Type of Identification Prod aP#v 111141 Notary Public State of Flonoa Louie Gabriel Machado g ,, g My COMMISSiW GG 279150 It,orw Expires 1112612022 Print, Type or We hope to work with your project soon. Thank you for choosing Lelack Construction! RECEIVED JU 0 J 2020 BY: X7. Miami Shores Village " Public Works Department (305)795-2210 Public works forms are available from the building department,10050 NE 2'a Ave., Miami Shores, FL 33138 PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property Permit#:( — DZ-2U 14 Z J ( ry 05- Name of Applicant (if utility see below): syti Q_'n'.5c_t Owner off the following described property: Legal Description: Lot 1-5 Block P t G Subdivision ']),gnn : rc�E M,',am; 1o1cS Folio #; I I -• a- 1 3ro- a>a - oa 10 Address: 14tcl r''S I`C38 f"2C0r r'M'•c* S.+rmc 331�1 UTILITY NAME: _ Qualifier/Authorized Address: City: Telephone: Email: State Certification or Registration #: _ State: Certificate of Competency # CONTRACTOR NAME: LL.AG'r-�'trac�cr4 7 Qualifier/Authorized Agent: YY t;�rtoet— t�t�ck— Address: (o'S7-4- -4 It aao City: State: !I-. ZIP: 3-3�4 3 Telephone�25-)a1P3-g1x Email; rn6w I�Lo.�y State Certification or Registration #: C 5c 1514 ortS Certificate of Competency #: Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way: '^� I�joicr t�rx�rs— 'Da, p r i�viht�a�/ Type of Work: ® Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: n» Address: City: Telephone: _ Registration #: State: Email: Value of Work for this Permit: $ 2 1 001` 00 Square/Lineal Footage of Work: A _-%� 54 5'r Permit Fee $100.Do Notary $ Bond $ sesr• Fees exrsa Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $ (if required) Total Fee Now Due $, Bonding Comparry s Name (if applicable): - Bonding Company's Address: City: State: rIA 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 meetthe standardsof all laws, regulation construction in this jurisdiction. I understand that separate permits must be secured for 1 AtG r'c— IQ0 S't- APPLICANTS 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-nf-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 who is pp ally known to me or who has produced I_ as Identification. - SignaturS ,e__ z Cot panYNtlllty Agem The foregoing instrument was acknowledgedJ�efore me this 2- day of 20 / Idy �nl;{� who is pe It nowrjto me or who has produced �J fi to as identifcation. NOTARYP L ' \ NOTARY PU Sign: j Sign: . Print:::: Lo Print: _ i' Notary Pudic Slate of Florda StAI: ,rar Notary Public State of Florida f Louis Gabriel Machado 43 d Louis Gabriel Machado My Comnsaslm GG 279150 My Coo,,",, GG 279150 . E Expires IIr 2022 qa rv� Espkes il2WO22 ♦. woo• . • .. •+�f rw............. • �ci �1-PLv APPROVED BY: ` . Public Works Director, or Designee Z017-O4-15 OR Usti 31822 PG 2389 LAST PAGE Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) ox-k._ y. owner of the followingdescribed roe hereinafter referred to as the �� rtY (address): t 4 q � � ce 5r ti-n; �► i �� e� � � _ �3 � � j Legal DescriptionDp-rfi s r.� J I'- Block llv Subdivision Folio # t 1 �i �- �,q - oa.� v Requests permission to .nstall (describe work): . �--- • •� 5ee. D2.aw: • Within thepublicright of way of (address) ire' log !N CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above -mentioned item(s) installed within the dedicated right of way. if it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise b ' ...y . _ y virtue of ,permitting the installatiomof these iterns-within'the public-n'g— f of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant , running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). Signature j7C3) Owner or Agent e fore oing instrument was acknowledged before me this = day of , 24 7.0 , by Naul krnbtu who is personally known to me or who has produced _ �Pl MQft as identification and w o did take an oath. -� n, NOTARY PUB copy Oti - yy r�W • 1 Y Srgn: Print: - � _ � '-.. . ;c::�i3i My Commission Expires: HA. 'Ey , uv ,� _ I • uit 'ts By 3711 NoWlY Putg1c Stste a! FtORda Louis Gsbsiei Machado , My Gommsion GG 279150 h Fxpites 11J2812022 s