PW-05-22-1257, 1298 NE 95th StMiami Shores Village 0 T
Public Works Department
(30S)795-2210 M,cl I 1 '22
Public works forms are available from the building department, 100S0 NE 21 Ave., Miami Shores, FL 33138
BY: — '
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
Permit#: �C_n7-��_ 4 57t,
IF ^05 2Z - j25-7
Name of Applicant (if utility see below): MIAMI DADE WATER AND SEWER
Owner off the following described property:
Legal Description: Lot Block Subdivision MIAMI SHORES
Folio #; 11.L22060144030_
Address:1298 NE 95 ST
UTILITY NAME: MIAMI DADE WATER AND SEWER
Qualifier/Authorized Agent:
Address: 3071 SW 38 AVE
City: MIAMI State: FL ZIP: 33146
Telephone: _ (305) 546-1948 Email: Jorge.Santa-Ana@miamidade.ctov
State Certification or Registration #: NIA Certificate of Competency # NIA
CONTRACTOR NAME: MIAMI DADE WATER AND SEWER
Qualifier/Authorized Agent: JORGE SANFA-ANA
Address: 3071 SW 38 AVE
City: MIAMI State: FL _ _ ZIP: 33146 �
Telephone:.(305) 546-1948 Email: WASD-NBSIRREVIEW@MIAMIDADE GOV
State Certification or Registration #: NIA Certificate of Competency #: NIA
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of
way: NEW 1" SINGLE SERVICE WATER INSTALL AND RETIREMENT OF EXISTING SERVICE
Type of Work: ❑ Paving 9 Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City:
Telephone:
Registration #:
State:
Email:
ZIP:
Value of Work for this Permit: $$1.200 Square/Lineal footage of Work:
`«••"Fees«««+.
Permit Fee $ 100.00
Notary $ Training/Education $ 0,20 Technology Fee $ 0.80 Scanning $ . __
Bond $ (if required) Total Fee Now Due $
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. 1 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 Author=zed Agent
The foregoing instrument was acknowledged before
me this day 20. ,� by
0 who
i ersonall n wn to me or who has produced
as
identification
NOTARY
Sign:
Print:
A6CA
SEAL: °�� Notary Pco�ic • State of -iorida
A` Commissicr -- in 20d279
•oF� My Comm.=xpires -"ec 24, 2026
Bonded through Natiora, votary Assn,
Signature
® -'Company/Utility Agent
The foregoing instrume t was acknowledged before
me this __ day of 20..ZZ by
►� who
is personall nown to me or who has produced
as
identification /I
NOTARY
Sign
Print.
`40tar`f Pvoiic • State of Fiorida
CWmissior A -1H 2O4279
#q Cgim, Eyores =ev 24, 2026
N ttMP®&4b riati 4t 4"y Assn -
APPROVED BY: Public Works Director, or Designee
2017-04-15
VILLAGE OF MIAMI SHORES
MIAMI-DADE COUNTY
SEC. 05 - 53 - 42
SPEED
LIMIT
30
POSTED SPEED
NO MIAMI DADE COUNTY
RIGHT-OF-WAY CONSTRUCTION
■ N
two Tuo py
SCALE: N.T S.
-1
22' GRASS PARKWAY
—
..
.. ..
;... .....'......'.
;.
-
'. 27' ASPHALT.;-. .'..'...."...-
.' ..' ..' ..'
......:.".-.......'
...............
••••
•
22'GRASS PARKWAY"•
• •
1
SIDE ALK..'
a.',.•�.'..
'. •
4'
..
1298
,
. .
LOTS 1& 2
BLK 85
D
m
M SHORES VILLAGE
i.
PUBLIC WORKS REVIEW
APPROVED DATE 1 t
GENERAL NOTES
1. LANE CLOSURES PER F.D.O.T. STD PLAN. INDEX # 102-604, 102-660
2. PAVEMENT RESTORATION PER M.D.C.P.W.M. R-21.1.
3. SIDEWALK RESTORATION PER M.D.C.P.W.M. R-13.1.
4. MAINTAIN MIN. 30" COVER ON ALL SERVICE LINES.
5. DO NOT SET METER(S) AT THIS TIME.
6.48 HOURS BEFORE DIGGING CALL SUNSHINE STATE ONE
CALL AT 1-800-4324770TICKET #. 125203248
❑ FL. CITY GAS V MDC PW & TRAFFFIC V COMCAST
TECO ❑ A.T. & T. ❑ ATLANTIC COMM.
F.P.L. 2f A.T. & T. DISTRIBUION ❑ CLEAR
DRAWN:OP/VL I DATE:05/05/2022 1 CKD:
NEW WATER SERVICE AND
EXISTING SERVICE
RETIREMENT AT
1298 NE 95 STREET
90007-SIRP-617
MIAMI - DADE WATER AND SEWER DEPARTMENT
GENERAL NOTES:
1. This Index applies to two-lane, two-way roadways with
work within Or near the intersection.
2. X = Work Zone Sign Spacing
See Index 102-600 for "x" and channollring device
spacing values.
3. Optionally, use "Flogger Ahead" sign with text (W20-74)
instead of "Flogger Ahead" sign with symbol (W20-7).
4. If Vehicles in a parkin zone block the line Of sight to
TCz signs, locate and post mount signs in accordance
With Index 700-10,.
5. If the work area extends across a Crosswalk. Close the
Crosswalk in accordance with Index 1024W
6. Oistriet Traffic Operations Engineer must approve temporary
signal phasing modifications prior to beginning of work
7. For unsignalized intersections, use Temporary Raised
Rumble Strips in accordance with index 102-603. Placement
of Rumble Strips an0 additional signs should Oegin at
F LAGCER sign location.
6. The "End Road Work" signs (0720-2) along with the associated
work zone sign distances may be Omitted when the work
zone will bC in place for 24 hours or less.
9. If the work encroaches on a marked bicycle lane or
ridable shoulder, Close the lane or shoulder in accordance
with the Plans.
SYMBOLS:
M Work Area
. CMnrlefizing Device (See Index 102-600)
CEO Type III darricode
Work Zone Sign
i Stop bar
Lane Identification and Direction of Traffic
Q' Flogger
2tj
This Cenf slhat
u:xr Lcraon
ws o .FwM. 'jroni Tnwc �
1 rea..1-io2s c«mr a�.I r r
nmuciw. OP
IJ. ..h M-4 FDOT P,ov n 110
WASD DURATION NOTES
C20-2
(SOO Note 9) W20-7 W20-IF
W20 1F " SP EEO
ROAD END 11. T
WORK ///---... ROAD WORK ROAD
AHEAD I I 30 WORK
[aI Ig POSTED SPEED AHEAD
RI-1 R3 2
STOP 5a to tar x X
Q NE 95 STREET-
3t ---- Z
m
> Less Th n 200
` •_•_■ YJ b m
O • ---
----�--- C f�
i � m
m STOP `
ENO
Z X W3-] AOAD 'NORK S'1'N 711VOS
RI-1
G20-2
ROAD
(See Note 9)
%4I
LWORK 90007-5IRP-617
f ENO AHEAD
ROAD WORK PHASESE 1
C20-z
(See Note 9) W20-fF N
LANE CLOSURE FOR WORK LESS THAN 200'FROM INTERSECTION
W20-IF
ROAD
WORK
AHEAD
I
C20-2
(See Note 9)
.. R]-1 eao R3-2 x
ROAD WORK STUP J
\to
For this specific project the work for water meter
connection will be performed by MD-WASD Wafer
Dlstr but crew.
Usually Will take to closure. lane between 3 to 6
VitkyLd2Ma,W1EW1,Evlr)iuteer2 hours, during a period maximum ofone (I)day.
Utilities IPevelopmeWt DiVislow,"Riovit of Way Section
Wlial'nl-Dade water avid Sewer l7epartynewt
FOG-2G8-53gG
2 OESCR/PTION:
ROAD
WORK
AHEAD
W20-1
END
ROAD WORK
GM-2
I8 (See Note 9)
Ir
--- - - - - - - J
V120-7 W20-IF
ROAD
fft
WORK
AHEAD
a
ry X� STOP ROAD NWORK
' • • I • • • • R3.1 • • G20-2
�� • al
• • • • • • RI• (See Noce 9)
� _ ••••��Y�QI. • • �� • • • • ROAD
i • „ • • • • AHEA
• ORK
••• •• • • • ••AHEAD ,
ENO
F W20-7 ROAD WORK
".C20-2 W20-1F
••• «�p•IOte 9) • • •• • !}•'
LANE CLOSURE FOAW WORK MORE WHA4 200, f 011 ::4RSECTION
• • • • • • •• • •
Fir zozl-22
REVISION N REFER TO MAIN DRAWING SKETCH FOR WATER CONNECTIONS DETAILS F��
I1/01/20 STANDARD PLANS.
• • • • • • • • • INDEX SHEET
TRIO -TARPS, T�VO-WAY, INTE1tSECTIOX WORM
102-�a04 1 of 2
••• • • • • ••• • •
• • • • • • • • • •
••• • • • ••• • •
GENERAL NOTES:
I. This Index applies to two-lane, two-way roadways with
work within or Mar the intersection.
2. X = Work Zone Sign Spacing
See Index 102-W for "x` and chermahzing device
spacing values.
3. Optionally, use "Flogger Ahead" sign with text (W20-7A)
instead of "Flapper Ahead" sign with symbol (W20-7).
4. If vehicles in a parking zone block the line of sight to
TCz signs, locate am post mount signs in accordance
With Index 700-101,
S. If the work area extends across a crosswalk, close the
crosswalk in accordance with Index 102-660.
6, Oistnct Traffic Operations Engineer must approve temporary
Signal phasing modifications prior to beginning of work
7. For unsignalized intersections. use Temporary Raised
Rumble Strips in accordance with Index 102-603. Placement
of Rumble Strips and additional signs should begin at
FLAGGER Sign location.
S. The "End Road Work" signs (G20-2) along with the associated
work zone sign distances may be omitted When the work
,one will be in place for 24 hours or less.
W20-1F
ROAD
WORK
AHEAD
G20-2
(See Note 91
ENO x
ROAD WORK
a
G20-2
(Sec Note 9)
W20-7
W20-IF
END £
ROAD WORK)
..
t
ROAD
WORK
AHEAD
50' to 70O I
x x
L— ___— —
LOSS��
_.
■
—� D x b— -- STOP
f>,.,.. X R3-i R7-7
ROAD I I '
WORK Q� �� ROAD `
AHEAD WORK
AHEAD ,
ENO
W20-IF �y2()_7 ROAD WORK
G20-2 W20-1F
(Sec Note 9)
LANE CLOSURE FOR WORK LESS THAN 200'FROM INTERSECTION
END
ROAD WORK
,,. 620 2 ..:.
(See Note 9)
9. If the work encroaches on a marked bicycle lane or
ridable shoulder, close the lane Or shoulder in accordance
with the Plans.
' ROAD W70-IF
90007—SIRP-617 WORK
AHEAD END
SYMBOLS: PHASE 2 ROAD WORK
® Work Are* I I C20-2 8IrSee Noe 9)
■ Chermelizing Device (See Index 102-600) m I (See Note 9) RI-1
® Type III Barricade END X W
Work ZO/M Sign D IROAD WOAK I
STOP O N
r `
Stop Bar Jhill A3-
M d] NE 95 STREET J �O
---�T----r�------- =
+✓j Lane Identification and Direction of Traffic IT!I
rn
a More Than 200' I >
O' Flogger m
■
b ■ • Z
p Tnis Oerafiea mat SCALE: N.T.S.
-�cHv Lotion u
aaz ama m.ao,m e", nanwa,v.m"xmao.xa �__ A 2W I R3-2
AED
STOP
WASD DURATION NOTES xFor This spec fie proJecl the work for water meterROADconnection will he perlormed by MD-WASD Water WORK • 8 ,� AD`
r� Fr Distribution crew. AHEAD
• • • • • • • • • ENO om -. • • • • • • • • • • • • ROAD WORK WORK
AHEAD
G20-?
Usually will take to dosure lane between 3 to 6 W20. IF W20 7 (See Note 9)
ViIL"y Lorada, WEWr, Evi mcer2 hours. during a period maximum of one(1)day. •W20-IF
••• ••• • •• • •
Intilities'DeVelopt�nentPivisioa,"Riyh+ofway5ec+iott • • • • • • • •
Miatmi-Dade water avid Sewer Departtmewt LANE CLOSURE JVR eRK M ORE •THAN 200' aFR OM:INWERSECTION
7S6-2G8-53g6 • • • • • •
LAST C OESCRIPTION:REVISION 0 FY 2021-22 • • • • • • • • • • INDEX SHEET
11101120 w REFER TO MAIN DRAWING SKETCH FOR WATER CONNECTIONS DETAILS F STANDARD PLANS ?'WO -!.A , T- WO -WAY, Dr-rERSEC 10K WORM 102-604 1 of 2
t
• • • • • • •
• • • • • • • • • •
• • • • • • • • • • at • • • • • • • • • • •
NOTES:
]. Cover or deactivate pedestrian traffic signal display(s) controlling
closed crosswalks.
2. Place pedestrian LOOS across the full width of the closed sidewalk.
3. For post mounted signs located near or se,,acenr t0 a sidewalk,
maintain A minimum 7' Clearance from the battdm Of the sign
panel to the surface of the sidewalk.
4."Sidewalk Closed" signs (R9-x )o may be mounted on pedestrian LOOS
In accordance with the manufacturers instructions.
5. Omit the Advance Closure LCO if it blocks access t0 other pedestrian
faculties (e,g., transit stops, residences, or business entrances).
SYMSOLS:
® Work Area
D Work Zone Sign
b Land Identification end Direction of Traffic
e-� Pedestrian Longitudinal Channeli—il Oevice (LCO)
0 � K.Y.L" oa'
WASD DURATION NOTES
For this specific project the work for water meter
connection will be performed by MD-WASD Water
Distribution crew.
Usually will take to closure lane between 3 to 6
hours, during a period maximum of one (1) day.
90007—SIRP-617
PHASE 3
SPEED
LIMIT
Advance Closure LCO 30 'S'.L N ;nVOS
(See Notes 4 and 5) POSTED SPEED
M4-gd - --- 019-]]AR N
ALK 81OEW%OBEO
- AHEAD
nETauR III III D
Z W9-]IAL In
D &7EW� nl7BE0 ti
< SIDEWALK
w10-IF
8 �!
= CLOSED HERE G
Ci O$
BIOEWALK CL08EO p Z ROAD
rc
UBE OTHER BIDE m Not m WORK
� (See NOtC 4) AHFAO
(See Not¢ 4)
NE 95 STREET
Advance: Closure LCO -
(See Notes 4 &; 5) —
_�_—
M4-98L �' SIDEWALKO-MO _- M4-981. _
DETOUR III III I;BE OTH�EW—BIDE—SIIJE gETW�
(S¢e9Note 4)
woAD FOUR
WORK M4-9dW
AHEM
W20-IF
PEOESTRIAN DETOUR
• • • • • • • • • • • •
• • • • • • • • • • • •
Vltky Lozada, w1Ew1, Ehr)ineer 2
Utllt he PCVCloptment DIVISmn, Right of way Section 000 • • • • • • • • •
yf wmi--PaA" Water nqd Sewer Pcpnrtm&v I- • • • • • • • •
766 2 o8-53q e • • • • • • • • • •
LAST 2O DESCRIPTION:
REVISION a FY 2021-22 • • • • • • • • • • • • • • INDEX SHEET
II1
0
I1
20 ` REFER TO MAIN DRAWING SKETCH FOR WATER CONNECTIONS DETAILS F STANDARD PLANS10 ST�]��t'�� CLOSL'R� 102_66p 1 Of 2
• • • • • • • • • • • •
• • • a • • • •
• • • • • • • • • •
• •• •• • • • •• ••
• • • • • • • • • • •
Miami -Dade County - Application Title
Type of Installation (/New Installation Q Repair/Maintenande Q Both
Method of Installation:
Q Bore VExcavation Q Both
Location of Installation:
Q Within Right Of Way Public Utility Easement Q Both
Will work commence
within 15 days of permit Q Yes No
issuance ?
Estimated Start Date: 30 DAYS
Canals maintained by Miami Dade County will require DERM approval.
VNOTIs maintained by Miami Dade County will require a permit from South Florida Water Management District.
cknowledged
Pedestrian Information
1. Does excavation fall within the swale and/or
(6eS Q No ""'
sidewalk area ?
. . ',a„'
2. Give dimensions from edge of pavement to
F-NTA-7 FT f +• • • • •
Work Zone in swa a area.
• .
• • � • • � •" �
3. Will work damage existing sidewalk, curbs
(/Yes Q No • • • • • •
and/or gutters ?
4. Will work obstruct pedestrian access to
Yes Q No •.. :"� • •
sidewalk ?
• •
5. Will work obstruct pedestrian crosswalk or
• • •".;
Q Yes (�No
ramp ?
•.'.,"
6. Will work obstruct bike path ?
Q Yes /No • • • • • • •
Pedestrians, including persons with disabilities
will be provided with a reasonably safe, convenient, and accescibiapath
that replicates as much as practical the desirable characteristics of the existing pedestrian facilita% f : a • e
Acknowledged
f'
Roadway Information (Are removing asphalt on a paved roadway)
7. Does the excavation fall on the asphalt of a
(?(Yes Q No
paved roadway?
8. Does excavation fall within a Signalized
Q Yes (�No
Intersection?
9. Does excavation fall within a Mid -Block
Q Yes t�No
Signal?
10. Does excavation damage any traffic loops?
Q Yes (/No
11. Have the roads, which are impacted by the
proposed work recently been paved or
Q Yes (VNo
resurfaced?
Traffic Control Plan
12. Will work require a lane(s) closure for
,./
Vehicular Traffic?
LVj Yes No
Q
13. Give dimensions from edge of pavement to
N/A FT
trench of pole:
14. Provide number of lanes and direction that
North: South: East: West: M
will be affected.
15. Please provide an estimate of construction
0 DAYS
time for which traffic flow will be affected
16. Functional classification of Roadway
❑ Arterial ❑ Collector VLocal
affected by work.
17. Does workzone fall within Section Line or
VNO
Half Section line roadway?
Q Yes
18. Posted Speed Limit within work zone.
30 1 MPH
At -grade Appurtenance (If you are placing a cabinet,
or some other type of equipment on the ground. Do not use
3/4/2014
Miami -Dade County - Application Title
Drainage Information
23. Do the proposed construction plans alter or modify not applicable d
existing drainage system? ..............................................
24. Does the proposed installation interfere with existing drainage not applicable d
facilities ?
Miami Dade County Water and Sewer Department's customer division proposes to perform the fallowing
work within your right-of-way
Total length of underground installation or
repair
Quantity
Water service connection: 55 LF
Sewer service connection: LF
Construction or Replacement of
Quantity
Sidewalk 5 LF
Curb & Gutter LF
Valley Gutter LF
Resurfacing
In Public Right
Quantity
0 SQF
Of Way
On private
SQF
property
Save Proceed
. .
....
......
......
... .
.....
.. ..
..
......
. .
.. .
......
.. .
•. •
. .
.