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PW-10-20-2324, 511 NE 101st StMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 511 NE 101ST ST, Miami Shores, FL 33138 1132060171090 Contacts WALTER HUNTER NEW Owner Champion Concrete Applicant 511 NE 101 ST, MIAMI SHORES, FL 33138 Jaime Basilio Other: 7063408793 10280 NW 63rd Terrace, Doral, FL 33178 Business: 7864024802 jagomez0616@gmail.com Mobile: 3059784333 CHAMPION CONCRETE Contractor JAIME BASILIO 10280 NW NW 63 terr 105, DORAL, FL 33178 Business: 3052528055 jaimechampion@yahoo.com Mobile: 7864024802 Home: 3059784333 Other: 7864024802 Inspection Requests: Description: Paver Driveway Installation VaLSqFeet: L86 0.00 % s: To.00 Fees Amount Education Surcharge $0.20 Public Works Permit Fee $100.00 Technology Fee $2.50 Total: $102.70 Building Department Copy Payments Date Paid Amt Paid Total Fees $102.70 Credit Card 10/21/2020 $102.70 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 this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: IAcertify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction ar zoning. Futhermore, I authorize the above named contractor to do the work stated. Authorized J Applicant / Contractor / Agent Date October 23, 2020 Page 2 of 2 Miami Shores Village Public Works Department Public works forms are (305)795-2210 available from the building department, 10050 NE 2" Ave., Miami Shores, FL 33138 PUBLIC WORKS PERMIT APPLICATION Permit Type- Work in the Right -Of -Way on Miami Shores Village or Miami -Dar-F)de Property Permit#: 1w- 1 70-7-324 Name Of Applicant (if Utility see below): JUALIE-4 Owner off the following described property, Legal Description: Lot � Block _ Subdivision Ae4;94103SALq'*'All) Folio #; P6 , -F '. Address: UTILITY NAME: Qualifier/Authorized Agent: Address: City: State: ZIP: Telephone: Email: State Certification or Registration #: Certificate of Competency # CONTRACTOR NAME: 6 OL/ CAALM"_C. Qualifier/Authorized Agent: A.—A;V-A- (.) Address: 102.XQ A)w 1.�;J 2111:w_L ;A4 Z 0 City: State: ZIP: f7_7 Telephone: iO4_4�r Email: State Certification or RegistriftGon #: Certificate of Competency #: Requests permission to install(describe work, attach separate page if necessary) in the adjoining right of way: & kiep-4' _.AZ1 V &p"' Type of Work: 0 Paving 0 Utility 0 Sidewalk [] Electric irrigation 0 Landscape[] Antenna [J Other, DESIGNER: Architect/Engineer: Address: City: State: zlp� Telephone., Email: A Registration Value of Work for this Permit; $ Square/Lineal Footage of Work: ***** Fees***** Permit Fee $ IQQ.O 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 jurisdictictn. I understand that separate permits must be secured for APPLICANTS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done incompliance 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 TOOTHE 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 $2,500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to the attachment Also, a certified copy of the recorded notice of commencement must be pos d at the job site for the first inspection which occurs seven {7} days after the public works permit is i s ed. In the absence of such posted notice, the inspection will not be approved and a reinspection ill be charged. Signature "Applicant or Authorized Agent The fore4ing instrument wa4 acknowledged before me this 74�7 day of 20 7- , by V�� .U"J F who is personally knpwn to me or who has produced .,j 17 as identification. NOTA Sign: Print: SEAL' Signature. 'Utility The foregoing instrume was knowledged before, me is,? day of 20-Wa by who is ersonally knower o me or who has pr uced NOTARY PUBLIC: Sign: Print: SEAL: MAGALY LLAPUR M 1' C't>!►IMISSgiN r L-sw�—. EXPIRh`S. M=h 25, --1WJ ♦##+Y####i######'4ralc�!#####iF##�k+U###+k###+lt####rR+#�### APPROVED BY: Public Works Director, or Designee 2017-04-15 Io3Eo lri.r �y • � 6 3 U Y• P1051 •n Cew�e�s L E11?$ Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (306) 795.2204 Fax: (306) 766.8972 COVENANT OF CON17T UCTION WIii N RIGHT OF WAY Whereas, (owner) rl/ �V 71 hereinafter referred to as the owner of the fglowing des bed property (address): S// /4/P- In / ff, AaAAd Legal Desc_9 'ption: Lot Block Subdivision / M,4 3'�> n�•tE /� -Fe--- --- — — — — sl.A Requests permission to install (describe work): TWW*7--f! CFN: 20200545575 BOOK 32116 PAGE 716 DATE:09/25/2020 12:00:14 PM HARVEY RUVIN, CLERK OF COURT, MIA-DADE CTY Within the public right of way of ( IN 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 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 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 Owner or State of Florida CountoW Miami Dade The foregoing instrument was NAOr.L feu/ %0 L, es 1 n1 NOTARY PUBLIC: Sign: Print: q--' iCe_r N eLi day of .%� 20 !! , by has produced ,rwtiwwoowrio woas�ra+�oo� oasa«��.>osr SEAL: eI. rrrur..r„ iered By: NE 104M St r12 NE 1030 ':t � t�1C13t ,, � �'„�* _ Nbp Ada p;4160aepY au• o.9s • j r��a 1 n snt�ut 10' ASPHAL T ALLEY 8 OAF STORY R SMACE #'511 .r ri,017MMj Proudly Serving the Florida Real MEL.ND Estate Community for Over 20 Years W W W.MELANDSERV ICES.COM K I j Z� VI— — \ _X_X TO-Auet7i"le fAu e.,L •- Pivicess cony peA44ir. , Qe`r oA� t elau e^Ati7 - �.. C 5L Y,6hli-P, --GMcl siSY�dt.T TntiSLy ,+ Ut�Cxr��e x W` �L7i(jjl�c.-/o 6xiz' . -fw,t c,_ jL� Afp 45 _ F, u� ZAWWA Y N. E. 101st STREET REVI W Scanned with CamSoanner