DS-07-23-1758Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: DS-07-23-1758
Permit Type: Driveways/Walkways/Slabs
Work Classification: Addition/Alteration
Permit Status: Approved'
issue Date:10/06/2023 Expiration: 04/08/2024
Location Address Parcel Number
9800 NE 13TH AVE, Miami Shores, FL 33138 1132050090280
Contacts
STUART LILLY Owner
9800 NE 13 AVE, MIAMI SHORES, FL 331382504
CHAMPION CONCRETE
JAIME BASILIO
10280 NW 63 TER 105, DORAL, FL 33178
Business: 3052528055
Mobile: 7864024802
Home: 3059784333
Other:7864024802
Contractor
jaimechampion@yahoo.com
Inspection Requests:
Description: CONCRETE PAD DRIVEWAY Valuation: $ 27,400.00;
Total Sq Feet: 2 640.00 ffzfta'"'�"i�
s _yam-,r�'iii 4 �rJa
Fees
Amount
Application Fee - Other
$50.00
CCF
$16.80
Concrete/asphalt/pavers, slabs, dways,
$175.00
swalks
DBPR Fee
$3.38
DCA Fee
$2.25
Education Surcharge
$8.40
Planning and Zoning Review Fee
$70.00
Scanning Fee (Manual)
$9.00
Technology Fee
$22.50
Total:
$357.33
Payments
Date Paid Amt Paid
Total Fees
$357.33
Credit Card
10/06/2023 $307.33
Credit Card
07/17/2023 $50.00
Amount Due:
$0.00
Building Department Copy
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: I certify that all the forec
regulating construction and zoning. Futhermore, I a
g information is accurate and that all work will be done in compliance with all applicable laws
ize the above name contractor to do the work stated.
Authorized Signature: Owner / Appkant / / Contractor / Agent
Date
October 06, 2023 Page 2 of 2
BUILDING
PERMIT APPLICATION
�191LDING ❑ ELECTRIC
Miami Shores Village
Building Department JOL 17 2023
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 By 40't
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 202D Tf''`
Master Permit No.1s�'01-23' ('792)
Sub Permit No.
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 4ky r' O
City: Miami Shores County: Miami Dade Zip: 331M
Folio/Parcel#: .11— 3z 6 0 0 rs�! po Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:
OWNER: Name (Fee Simple Titleholder): 5'7U/�& 1 Liu)' % j4pe-T-LI LLj' Phone#:
�y e 1 z , I// �
Address: `�K ! 0 " �/ 1/ 16
City: State: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: r /i��iN ���� Phone#: �V_7
Address: jjM
Email:{
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Certificate of Competency #:
Address: City: State: Zip:
Value of Work for this Permit: $ `z zq oy Square/Linear Footage of Work: 71�4 u
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee $ �•� Permit Fee $ (I � CID CCF $ ((P %V CO/CC'
Scanning Fee $ DCA Fee $ Q- VS D B P R $ ';d�9OZ Notary
Technology Fee $ 1,2• Training/Education Fee $ �G •+y Double Fee $
Structural Reviews $_� P&Z Review $ ��-� Bond $
nab
TOTAL FEE NOW DUE $
(Revised04/05/2022) W7• -3�)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 f such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or GENT ONTRACTOR
The foregoing instrument was acknowledged before me this
�7 day of L&WI, ' 20 by
who its personally known to
me or who has producedbgoo--713--6z 3Lffb73-'Z 32�b as
identification and who did take an oath.
NOTARY PUBLIC:
The foregoing instrument was acknowledged before me this
day of 20 c- by
who is personally known to
me or who has producedas
d���j�/�0�%/%
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Sign:_
Print:
Print:
Seal:
Seal:
MAGALYLLAPUR
*: *'
MY COMMISSION # HH 371080
APPROVED BY
Plans Examiner
MAGALY LLAPUR
MY COMMISSION # HH 371080
EXPIRES: March 25, 2027
#########################################
700,
Zoning
0X1�1
(Revised04/05/2022)
Structural Review
Clerk
EARLETON SHORES EARLETON SHORES
LOT 2 BLK 2 EXIST. 5.0' UTILITY EASEMENT LOT I BLK 2
PB 43-80
PB 43-80
(NOT A PART) _EXIST. C_ONC SLAB (NOT A PART)
EXIST, UTILITY POLE
4.0' `O
- — — — — — — — — — — — —
70.4'
EXIST. PALM
TREE (TYPJ dry lr
EXIST. POOL
i
i
i
LQ'
G�
WCV
�CC<co a ( EXIST. BRICK SLAB
� I
1 L
EXIST. ASPHALT DRIVEWAY
TO BE REPLACED WITH W. Y
6 THICK CONCRETE PADS
DRIVEWAY AS PER PLAN (TYPJ
EXIST, ONE STORY SM.
9800 NE 13 AVE r
WAMI SHORES, FL 33138 / \\
FOLIO II-3205-009-0280 \
EARLETON SHORES \
LOT 18 E EI/2 LOT 17 BLK 2 \
PB 43-80
10'XIO' VISIBILITY -
TRIANGLE AT
BOTH SIDES (TYP)
EXIST, WALKWAY TO BE REPLACED
WITH 4' THICK CONCRETE
WALKWAY AS PE12 DETAIL
y \ O
o EXIST. SWALE
7' 7,0_1
`Y,�''•',1i o I
EXIST. FIRE
HYDRANT
0
u)
—EXIST. CONC SLAB N\\ �Q
PROP. TREE ROOT---,4
P�D,OPOSED D�ZINEVV4Y PLAN
{ SAW CUT EXIST.
ASPHALT PRIOR
' TO INSTALLATION
OF PROP,
CONCRETE PADS
' APPROACH, TO
BE FLUSH WITH
EXIST. ASPHALT
PAVEMENT (TYPJ
FENCINGTI` YPJ
WALKWAYAY TO (T+` x�
EXIST. EXIST. TREE (TYR)
T
REMAIN
113.83� - - — RIP - - - — - - — R(W 90°21'36' /
T=25.16
• • A=39.43' /
EXIST, SWALE EXIST. SWALE
o i EXIST. CATCH
Cq BASIN
—EOP-------------EOP-----------EOP---
mi n
IO CWM - 7MVERTME - PAVM
10280 NW 63rd Terrace # 105
Doral, Florida 33178
Office: 305.252.8055
Mobile: 305.978.4333
www.championconcreteandpavers.com
--NE 98.8T ------
D
SCALE
1 inch = 20 feet.
0 10 20 40
GRAPHIC SCALE (IN FEET)
LOT SIZE I
I12,189 SOFT. i
i
TOTAL AREA IZ189 SO. FT.
3.
4.
98001E 13 AVE AUG U 2023 6.
MIAMI SNORES, FL 33138 Bpi'._ . , 7.
8.
OWNER: STUART LILLY & W JANET 9
FOLIO: I I-3205-009-0280
SCALE: 1 "=20' 1 DATE: 08/09/23 1 PROJECT # 23-148 1 SHEET 1 OF 1
6'OR4'
(AS INDICATED)
--I4.514
6" OR 4" (AS INDICATED ON
PLANS) CONCRETE PAD (3,500
PSI MAX.) WITH FIBER MESH
ASTRO TURF
CONCRETE PADS DETAIL
NTS
50% TOTAL LANDSCAPE MIN.
12,189 X 50% - 6,095 MINIMUM
REQUIRED
6,100 SQFT PROP. GREEN
AREA (TOTAL)
V
WELL COMPACTED
BASE
i
I o� �
Tli
L L _ _ _L R=25'
A=9002I'36'
50% OF THE FIRST 25' FRONT YARD T=25.16
2,578 SOFT ON FRONT YARD A=39.43'
(1,289 MINI" REQUIRED)
OPEN LANDSCAPE CALCULATION
NTS
SCOPE OF WORK,4F.
EXISTING ASPHALT DRIVEWAY, APPROACH AND WALKWAY TO BE REMOVED A �NJO
REPLACED WITH PROPOSED CONCRETE PADS.
POUR 6' CONCRETE (3,500 PSI MA)0 ON DRIVEWAY AND APPROACH AS SHOWN ON PLAN PER DETAIL
POLP 4' CONCRETE (3,500 PSI MA)0 ON WALKWAY AS SHOWN ON PLAN PER DETAIL
TRIANGLE OF VISIBILITY SHAM BE KEPT CLEAR OF VISUAL OBSTRUCTION BETWEEN A HEIGHT OF TWO AND
HALF (2.5) FEET AND EIGHT (8.0) FEET ABOVE THE ESTABLISHED GRADE
50% OR GREATER OF GREEN AREA WILL BE MAINTAINED ON THIS PROPERTY,
NO TREES BEING REMOVED FOR PROPOSED DRIVEWAY.
ALL WATER WILL BE RETAINED WITHIN PRIVATE PROPERTY.
ALL IMPROVEMENTS ON THE RIGHT OF WAY AREA DAMAGED DURING CONSTRUCTION TO BE RESTORED TO
ORIGINAL OR BETTER CONDITIONS.
REMOVE ALL CONSTRUCTION DEBRIS. Miami Shores Village Building Department
Zoning Dept. A %1 Date (1
Building Deni.- Date
Subject to a:m-�plia e with all F de I,
State acid County rules and reg lations.
�-•67-2-3 •I-1 P\,V-07-Z3-•17E,:i
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
STATE OF (FLORIDA)
COUNTY OF (DADE)
The undersigned Affiant, �Jufi f'i 1 L (LL ! does hereby attest that
(Property owner)
The attached survey, performed by i ,410W 5 A9 �- Mw , /,,/ C
p (Name of surveyor's company)
For address:
Performed on 47- 8% (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.
Further, Affia h nauy�'
Property Owner Signature
Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this //2day of��?��%��—� ���o?��
Affiant is personally known to me, —prod ucedOL- %�%�� �� ?Q46enti if cation.
Revised on 5/22/2009/ Revised on 6/12/09
Nota
MAOALY LtMUR
.; += MY COMMISSION NH 371080
•�rF OF F ��C:
EXPIRES: March 25, 2027
i e i }
H16�
-�;7 N
W
i S L
L
95'9L Lll
7
7-
1s
�18�
Sly
<j �d
4 �
V
w�
,QS'LS
4
S �
tu
If V1
Y
1tY't�7� /,1t71117, S �
i $9'SS
i os z� �L'
v I I c'O'S
6
�Q
i
_LA
s
1
1
LO r3 J ca-
4- O O
0- CO O ry
a� U U ^ 7D V
1
I h� `.-,rM flW 7_
• N
1 ��t•r42 p �d��0
1 -11-
4p-fl'0
l
v �
°)I'SZ _-L
a�,IZo06 =�
IVL•d(j _9n?Jn )
It 1
ZU' _
>
<
J
.-C
2 L
>
Q
O U
}
ro
V
N
-4
:D Z R
v q
.
Z °� O
II
e `�
(n
W
J
Q =
U
i`I 3E
v
Z
Z
w� c
<
Z
r
�o
�•i c
�
•r-i
Z� -C
0) 0
rn
��j
w w o v
U 0
V1 T-C
•
` N
>��Qyva`+��
c�
�`L•i
�L „��z
Z
0)0
L
I~ 0
� �
Q
N LL C
A
`1
H W
ro m
4-4
v
_u
U O
a) O
o
V)
O�
y
�
I
c
>.
I
-
_
In
Z
�3
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: PW-07-23-1781
Permit Type: Public Works
Work Classification: Public Works
Permit Status: Approved
Issue Date:10/06/2023 F Expiration: 04/08/2024
Location Address Parcel Number
9800 NE 13TH AVE, Miami Shores, FL 33138 1132050090280
Contacts
STUART LILLY Owner
9800 NE 13 AVE, MIAMI SHORES, FL 331382504
Contractor
JAIME BASILIO
10280 NW 63 TER 105, DORAL, FL 33178
Business: 3052528055 jaimechampion@yahoo.com
Mobile: 7864024802
Home: 3059784333
Other:7864024802
Description: CONCRETE PAD DRIVEWAY Valuation: $ 27,400.00Inspection Requests:—
Total Sq Feet: 2,640.00
Fees
Amount
Education Surcharge
$8.40
Public Works Permit Fee
$100.00
Technology Fee
$10.00
Total:
$118.40
Payments
Date Paid Amt Paid
Total Fees
$118.40
Credit Card
10/06/2023 $118.40
Amount Due:
$0.00
Building Department Copy
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: 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. Futhermore, I ?thorize the above named contractor,tgrdo the work stated.
Authorized Signature: Owner
/ Contractor / Agent
Date
October 06, 2023 Page 2 of 2
_" k_ J=.0 rt v awl ✓
Miami Shores Village ,JUG_ jl (� 2023
Public Works Department
(305)795-2210 BY: i �I
Public works forms are available from the building department, 10050 NE 2"d 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#: rs'n--x?� A79b `
pW—c0-1 23--II
Name of Applicant (if utility see below):
Owner off the following described property:
Legal Description: Lot le Block Subdivision 1� tj0k/ y9(9116
Folio #; 20 Cq_ 0 Wd
Address: tT ?,U f ,di/ ,
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: Certificate of Competency #
CONTRACTOR NAME:
Qua lifier/Authori ecl Agent: n
Address:
City: State: ZIP:
Telephone: 7i ?/ Email:
State Certification or Registration #: Certificate of Competency
Requests permission7,i
install (describeork, attach separate page if necessary) in the adjoining right of
way: �/�%�1 l `f', rf "5 ,
Type of Work: ❑ Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna
DESIGNER: Architect/Engineer:
Address:
City: State:
Telephone: Email:
Registration #:
❑ Other:
ZIP:
Value of Work for this Permit: $ (/ 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. 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 i issued. In the
absence of such posted notice, the inspection will not be approved and a reinspectio1will be charged.
Signature
Applicant or AutholVed Agent
The foregoing instrument was acknowledged before
me this day of 20,;t?. by
who
is personallyknownto me r who has pro uced
/
6 ! -%?- �o�- - � _ a s
identification.
NOTARY PUBLIC:
Sign:
Print:
SEAL:
Signature
Company/Utility Agent
The foregoing instrume*was acknowledged before
me this 17 day - o 20 „ by
me, -A • On& ;,- ` who
is perso ally known to me or who has produced
pl�l II- o as
irlantifirntinn
N OTC
�`gJz Sign:
Print
Y LLAPUR SEAL;
MY COMMISSION* HH 371080
EXPIRES: March 25, 2027 •..
%f,�,.,?�?",•. �`• "�•: HEBERT MARTINEZ
MY COMMISSION 6 HH 323276
EXPIRES: October 18, 2026
APPROVED BY: Q \ Public Works Director, or Designee
2017-04-15
Miami Shores Village
Public Works Department
(305)795-2210
Public works forms are available
from the building department,
10050 NE 2"d Ave., Miami Shores, FL 33138
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
OR F`,Fi. :'
Whereas, (hereby referred to as the owner) ST-UART M` (_Lul
Of the following described operty:-7111
(�'r/t�j✓>? f l
Legal Description: Lot Block Subdivision `; Folio #; I / r�
Address:
Z/
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way:
IN CONSIDERATION of the approval of this permdby 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 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 fully authorized �repres , tative).
Signature ii / �/ V� L&x
Owner or Authorized ent
State of r-L
County of,/�l!
The foregoing instrument was acknowledged before me this l) day of 20Q!�, by
�(/// who is personally known to me or who has produced
as identification. /9 / - Wr - 1-),5�_o,
NOTAR PUBL C:
Sign:
Print: �����SEAL:
MAGALY LIAPUR
* *= MYGOMMISSION#HH371080 Documents are recorded at the Clerk
'�.
t,P: EXPIRES: March25,2021 MIAMI-DADE COUNTY RECORDER, CC
f,F,.
22 N.W. First Street, 1st Floor, Miami,
2017-04-11
OR P K "k_3 79 PG emu-1_I26
STATE OF FLORIDA
COUNTY OF MIAIMI- DADE
I HEREBY C RTIFY, that on this day of A.D. 200, before me personally
appeared,A
to me known to be the person described in and who
executed the foregoing Covenant to the Town of Miami Lakes, a body Corporate, and a political
subdivision of the State of Florida, and acknowledged to me the execution thereof to
be free act and deed for the uses and purposes therein mentioned.
WITNESS my signature and officials seal at in the County and State
aforesaid, the day and year last aforesaid.
Commission expires:
(ACK LEDGEMENT - CORPORATION)
STATE OF FLORI
)
COUNTY OF MIAMI-DAD
BEFORE ME, the undersigned out ty
both being to me r
and Sec
Notary Public, State of'��G�ti"` t/
4 �' ;•; MAGALY UAPUR
MY COMMISSION 1f HH 371060
� �'`.•` EXPIRES, March 25, 2027
'bf OF P�, `,
, this day personally appeared
ISQ'Inown and by me to be the
retary,of the
_ and
President
a Corporation under the laws of the State o and which said
Corporation is known by me to be the person desc . d in and which executed the foregoing.
Covenant, the said officers of the said Corporation bein ewise known by me to be the officers
thereof who, in their official capacities as such officers of sai orporation executed, signed and
delivered the said Covenant as the act and deed of said Corp Lion, and the said officers of
said Corporation then and there severally acknowledged to and be e me that they executed
the said Covenant, acting in their said official capacities, for and as the a and. deed of the said
Corporation and in its name, and impresses thereon it Corporate Seal, fo the uses and the
purposes therein mentioned, and after being thereunto by the said Corporation ly authorized
and directed.
WITNEESS my hand and official Seal at in the Coun nd
State aforesaid, on this, the day of A.D. 20_.
Notary Public, State of
My Commission expires:
STATE OF FLORIDA, COUNTY OF MIAMI•DADE
I HEREBY CERTIFY that this is a true copy of the
r !`r c� t1' SNPn day of x
OL1e l ` ' I ULJ t1� A� AD 20 _.+- --- �� (
imrunty CoutsD.C.2�
aeaK ci9.�. .
i
sl
c
+F r.ntP .