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1084 NE 91 Terr (6)July 20, !Permit No cf - Application is hereby made for the approval el the de statement of the plans and specifications herewith submitted for the bui:di2g a ai21,-.v structure herein described. This application is made :., compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws 01 the State of Florida, all ordinances of Miami Shores Village and all rules and [regulations of the uildirg Divisiet3 of .Miami Shores Village shall . s4 complied with, whether herein specified or not. A copy ©f approved plans and specifications circza be rkaa aa building during progreas of work. Ada ownefo Minn tmli rew r. /nein z o Registered ACtZ and/or Engineer - ', Septic Tank P00 1/ z q 0 IN r ittPn ' N "ert „ „,— ' , J., - ' (" o e./ e, aaa u 4 Dczcaisstion Lot _....14. ION! NE 91st r szvet anz Number where worh is to bo errnvi-- o Street. State work to be New Building. Rain cane—. --. Addition. Amount el Remit $ STATE OF FLORIDA, COUNTY OF DADE. NOTE: A Yo-finsit=tion azaterialo /cn war armed and patsy:era of buildimg (1y Rom) Iy Comsrdasise ErgArse GAOAMI SHORES VILLAGE PLU ING 8.- SPECT1ON DEPARTMENT APPILICATI N FOR PLUMBING PERMIT ( Signed )_ 10P4 Stye__ -- • .............. ..... -• Repairs X X N. ef DOTICO Size Septic lank-- _Type of Tank 7,, o f m 111 :Pt of Tank or Drain Field from Well Nature of Weiss. Supply: City—wa Sim of Soakage Pit. (Signed) gS/ Th3 undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employee al under the Florida Worlanen's Compensation Ac ing Section 5988, Compiled General Laws of Florida Permanent Supplement, and It czm.. plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him etc vdo7'Y ec performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice ce Tizticvo co cr.> required by the Act. The undersigned agree t© employ only such sub-amtractors, on .work to be perfoed tt es thic ieia, e?c, licensed by mwsg, Shores Village. Ptfactese Inna's,ar. dere ms, the undersigned uthcy @ notary public, duly authorized to administer oaths and take aclolowiesignamta, peareagEsP to me 'ell known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction t he bag easefully read the foregoing application, and that he al en by him rotated aro Qrue. Notary Public, State of Florida Plumbing XsIsszazz. nme, gaZ C Et...13 wiE be made when such rwisapsotku is slaw twommasy by improper notice kw tospeg C2 Ly CLOSSVG 0 AVRI T U DS GMC LAVA. TOMEI SI N30 GLOP SINKS L*UNOPY Tune URINALS CATCH a As iN FLOOR DRAIN DRI N K I NG FOUNT' NE T- Y.S1'A I X V U I DORM. LIST — -.-- CNSCH _ _ _ — 3 EPTI C TAPIR SSW SA COMM. DRAIN FIELD SOAKAGE. PI V GRIMES TRAP SOLAR NEATER Dew WELL drpumn. SYSTEM EPA NC a POOL - — COMM. — _ D RUMS ---..----.— July 20, !Permit No cf - Application is hereby made for the approval el the de statement of the plans and specifications herewith submitted for the bui:di2g a ai21,-.v structure herein described. This application is made :., compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws 01 the State of Florida, all ordinances of Miami Shores Village and all rules and [regulations of the uildirg Divisiet3 of .Miami Shores Village shall . s4 complied with, whether herein specified or not. A copy ©f approved plans and specifications circza be rkaa aa building during progreas of work. Ada ownefo Minn tmli rew r. /nein z o Registered ACtZ and/or Engineer - ', Septic Tank P00 1/ z q 0 IN r ittPn ' N "ert „ „,— ' , J., - ' (" o e./ e, aaa u 4 Dczcaisstion Lot _....14. ION! NE 91st r szvet anz Number where worh is to bo errnvi-- o Street. State work to be New Building. Rain cane—. --. Addition. Amount el Remit $ STATE OF FLORIDA, COUNTY OF DADE. NOTE: A Yo-finsit=tion azaterialo /cn war armed and patsy:era of buildimg (1y Rom) Iy Comsrdasise ErgArse GAOAMI SHORES VILLAGE PLU ING 8.- SPECT1ON DEPARTMENT APPILICATI N FOR PLUMBING PERMIT ( Signed )_ 10P4 Stye__ -- • .............. ..... -• Repairs X X N. ef DOTICO Size Septic lank-- _Type of Tank 7,, o f m 111 :Pt of Tank or Drain Field from Well Nature of Weiss. Supply: City—wa Sim of Soakage Pit. (Signed) gS/ Th3 undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employee al under the Florida Worlanen's Compensation Ac ing Section 5988, Compiled General Laws of Florida Permanent Supplement, and It czm.. plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him etc vdo7'Y ec performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice ce Tizticvo co cr.> required by the Act. The undersigned agree t© employ only such sub-amtractors, on .work to be perfoed tt es thic ieia, e?c, licensed by mwsg, Shores Village. Ptfactese Inna's,ar. dere ms, the undersigned uthcy @ notary public, duly authorized to administer oaths and take aclolowiesignamta, peareagEsP to me 'ell known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction t he bag easefully read the foregoing application, and that he al en by him rotated aro Qrue. Notary Public, State of Florida Plumbing XsIsszazz. nme, gaZ C Et...13 wiE be made when such rwisapsotku is slaw twommasy by improper notice kw tospeg C2 Ly STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILO` 'HUE BF,Js 9: ©1 `�;5 ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION NO 5(I`J07nU,LZ' :C'JL P rmit Number s , 6 r5 kSr � 7 11 f STEM INSTA O N INSPECTION 76 � ION AND FINAL 1 ` QI� 'r ^Ca� C�';,���� Installer Applicant 7. 17` f� dt Proper tank legend: Yes Tanks watertight: Yes Pcaor tank outlet device: Yesj No Manhole or marker to grade: Yes Dralnfield Trench 0,c�,a�Ga Width Meet feet feet feet feet feet Total= ft Systems located as permitted: Yes Date .... ............m_.._.o.. _PART Approved by: No Length width Length feet X fe feet feet Length` foot x gee; _ feet feet Proper No. cz'- ;:..:,.es: Yes feet feet Proper pipe sepa, -f lo': Yes No __ — I F Tank material Tank size: gallons Total = Systems including plumbing stub -outs installed at proper elevation: Yes No Average depth to drainpipe invert from finished grade: inches Maximum Average depth of drainfield gr vel: I V inches Minimum depth of gravel: Proper gravel size: Yes No Gravel is suitable quality: Yes �^ p g q y Dackflll or fill material as required: (Quality) Yes _2 No (Quantity) Yes / No Other findings: .1w4? V ::spected by: Zi_f<— 472,1 d FORS —H Form 4016, Jan 86 (Replaces Feb 85 edition which may be used) (Stock Number: 5744-002-4016-4) Tank Manufacturer be L INSTALLATION , , PROWV, - -o,,.. Tank level: Yes ga ft Distribution box ievel: Yes N i AN APPROVED INSTAL TION 1OES NOT GUARANTEE PERFCM:VlAYC COUNTY ?UBCI I- ;EALTH UNIT Nc1e: Completed copies of this form will be provided to the applicant, installer aid tSpe Peen 2 of 2