Re-Occupancy Application REOCC-04-23-919ii�` / � � f
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y Z$ Miami Shores Village
Building Department
r �(/ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
V Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
RE -OCCUPANCY
APPLICATION
PermitNo.REQ�C'-04-Z3 4'l'�
Contact Name: Colin Lienhard Phone#:571-594-0817
Buyer: Bill & Marie Diggs
Seller: Colin Lienhard & Daniel Toral
Realtor: Christina Femandez Company Name: Acc Realty
Property Address: 19 NW 92st
City: Miami Shores State: Florida Zip; 33150
I hereby certify that I understand that the zoning for this property is for single-family residential use and that it is
unlawful for more than one family to reside therein- I also understand that any Certificate of Re -Occupancy that
may be issued by Miami Shores Village certifies only that the referenced property is being used for single family
purposes and that such certificate does not constitute any representation, warranty or certification as to the
condition of the dwelling or other structures on the property.
APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accurate.
Applicant
Signature:
The foregoing instrument was acknowledged before me this
day of 6v!qj 1 20Z, by Cahn L i l r rl a rd
who is personally known to me or who has produced
As identification and who did take an oath
NOTARY PUBLICAmerica Miranda
:! ••°..
� Comm.#GG914883
sign: O�liCf'.l� � j�T• s: 26, 2024
Print: M i r I C a M (Ll vl d Z) ' p° nn" ��u teary
My Commission Expires: S'WAI 1412v24
Building Officials Approval:
Re-Occ $60.00
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Total $ 60
REV 4-10