PW-11-19-2674, 142 NW 101st StMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date: 03/30/2021
Parcel Number
142 NW 101ST ST, Miami Shores, FL 33150 1131010220180
Contacts
Permit NO.: PW-11-19-2674
Permit Type: Public Works
Work Classification, Public Works
Permit Status: Approved
Expiration: 09/20/2021
1981 Owner HOME OWNER Contractor
Sekou Caldwell HOME OWNER
142 NW 101, MIAMI SHORES, FL 33150
Business: 2065124708 sekoucaldwell@hotmail.com
c nests:
Re
Description: REMOVE REPLACE EXISTING DRIVEWAY PAVER Valuation: $ 1,000.00 Inspect -4949 Inspection Re
TotalSq Feet: 160.00
Fees
Amount
Education Surcharge
$0.20
Public Works Permit Fee
$100.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$111.70
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.70
Credit Card
03/30/2021 $111.70
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 tly) permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required)0eELECTRIt;AL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFF AVI I=allegoing information is accurate and that all work will be done in compliance with all applicable laws
re ulatin s u inauthorize the above named contractor to do the work stated.
Signature: owner / 9ipplicant / Contractor / Agent Date
March 30, 2021 Page 2 of 2
Miami Shores Village JD
Public Works Department
(305)795-2210 NOV ®� Zf�1
Public works forms are available from the building department, 10050 NE 2nd Ave., Miami Shores] 38
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
Permit#:? V Y ,I H- I
Name of Applicant (if utility see below):
Owner off the following descrioed property:
Legal Description: Lot LBlo k 3 Subdivision C,�a� C(S'S
Folio #; l - 3�0 \- 62Z - o 12)%
Address: 1 LA2_ NL-� ICE\ S-\WX-tT f M-S��Z �26 �L S366
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City:
Telephone: Email:
State Certification or Registration #:
CONTRACTOR NAME:
State:
ZIP:
Certificate of Competency #
Qualifier/Authorized Agent:
Address:
City: State: ZIP: _
Telephone: Email:
State Certification or Registration M Certificate of Competency #:
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of
way: ' ZGP Llsy�C_ SJ C13. L,_j A-� Awc�, c; nzicz-
A�b �U--_QLn�' a- C-,(4\&
Type of Work: ❑ Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City:
Telephone:
Registration #:
Value of Work for this Permit
Permit Fee $ 100.00
Notary $
Bond $
State:
Email:
ZIP:
$ Square/Lineal Footage of Work
***** Fees*****
_ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
(if required) Total Fee Now Due $ 1 1 1 , �TJ
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 tho ed Agen
The foregoing instrument was acknowledged before
me this day of N , 20�J by
� F kOy who
is pers ally known to me or who has produced
as
identification.
NOTARY PUBLIC:
Sign:
Print:
SEAL:
Signature
Company/Utility Agent
The foregoing instrument was acknowledged before
me this day of , 20 by
is personally known to me or who has produced
as
identification.
NOTARY PUBLIC:
Sign:
Print:
AA-.19
APPROVED BY: Public Works Director, or Designee
who
2017-04-15
Miami Shores Village
Public Works Department
(305)795-2210
Public works forms are available
from the building department,
10050 NE 2"1 Ave., Miami Shores, FL 33138
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
CFN: 20210207973 BOOK 32414 PAGE 4844
DATE:03/24/2021 03:13:08 PM
HARVEY RUVIN, CLERK OF COURT, MIA-DADE CTY
Whereas, (hereby referred to as the owner) �t,
c cmw �1 /
Of the following described property: "�
Legal Description: Lot_ 1 Block Subdivision Folio #; 1— �— 022 : QSl
Address: 142- N_W._.... 16 )1 &C (A'14M_� ��L 1�_
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way:
1 �-12 w 1'" vr ,Q-A '50.0,4sc F_ 33`lcl (
IN CONSIDERATION of the approval of this permit by the village, the owner agrdes 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 Miami -Dade County to make repairs or maintain said items within the public
right of way including restoration of the 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 herby agree to indemnify and hold Miami Shores Village or Miami -Dade County harmless from any and all
liability, which may rise by virtue of permitting the installation of these items within the public right of way.
3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 14 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 obligation has been
cancelled by an affidavit filed in the Public Records of Miami -Dade County, Florida by the Village Manager of Miami Shores
Village (or his full uthorized representative).
Signature
Owner or Authorized
NAyeW
State of ,<3V_J PP•
County of "(.P-MI — �E
The foregoing instrument was acknowledged before me this __Le day of MA J?,C" 20 2l by
who is personally known to me or who has produced
L-ek=— N as identification.
NOTARY BLIC:
Sian:
Print: t (vtitP-'� SEAL:
SINDIA ALVAREZ
P.
MY COMMISSION # GG 238273
EXPIRES: September 3, 2022
•P! ,, °• Bonded Thra Notary Pubue Uederrr ftm
Documents are recorded at the Clerk of the Courts,
MIAMI-DADE COUNTY RECORDER, COURTHOURSE EAST,
22 N.W. First Street, 1st Floor, Miami, FL 33128.
2017-04-11