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PL-09-1351Project Address Owner Information VILBRUN LALANNE Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 190 91 Street Miami Shores, FL 33138- ISIMM'Ar Mtge ... Aar Contractor(s) Phone Cell Phone ALL PRO SEPTIC & SEWER INC / ALL (305)635 -3002 (305)206 -4473 Type of Work: PLUMBING Type of Piping: SEPTIC & DRAINFIELD Additional Info: Bond Retum : Classification: Residential Fees Due Bond Type - Contractors Bond CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $300.00 $4.20 $1.40 $525.00 $9.00 $50.00 ($50.00) $13.12 $852.72 4 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 authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant Agent Building Department Copy August 19, 2009 Address Parcel Numbe'- 1131010190080 Block: Lot: 190 91 Street MIAMI SHORES FL 33138 -2810 Phone Invoice # PL -8-09 -35627 PL -8-09 -35627 PL -8-09 -35627 Check #: 6906 Total Amt Paid Amt Due $ 852.72 $ 50.00 2,72 $ 852.72 $ 350.00 $ 852.72 $ 852.72 $ 0.00 Bond #: 1882 Applicant VILBRUN LALANNE Valuation: Total Sq Feet: 0 For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Top Out Re Pipe Main Drain Underground Rough Heater Water Service Water Main Final Lavatory August 19, 2009 Date an Status..AP Expiration: 02/14/2010 CeII $ 7,000.00 1 BUILDING PERMIT APPLICATION FBC 2004 Tenant/Lessee Name E -MAIL: Contractor's Company Name State Certificate . r Registrati E- MAIL. r Architect/Engineer's Name (if applicable) Value of Work For this Permit S N3i r Ur$ AiH3Hi 4 ���3e'tTffyyi � `' es r9h W'�rk3 7 .; Submittal Fee $ Notary $ Training /Education Fee $ Scanning $ Radon $ Bond $ Code Enforcement $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type: Plumbing / /I Owner's Name (Fee I/ // Simple Titleholder) / L 5P�1. . I'd/4bL/6r # eS Owner's Address / 0 AIZ q/5r City /f 1 1 QhfirGS State Zip 13 /3 V Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade FOLIO / PARCEL # � 1 .3 /o i -- ©19 —00 ko Is Building Historically Designated YES NO X. KAiteration Contractor's Address City /4/ 0.417 / Z- State / Qualifier Name SgWkii taai34 o abss�i� ea Wale - 3i1l A w4-1 VOS SS; del eo a n. avaT ]J MMei DPBR $ Permit No. 91. ' %' 0 ' 13 Master Permit No. Double Fee $ Zip 3313V oe) p hone # ,'/' b c3 - 3c2- Zip 33/412...., Phone # g/&5 5 gt,e92.. Certificate of Competency No. Phone # L04— N14_ ❑ Demolition Sep �YxxaYxta4 de o: &x ste drxx4exlexx�Y 4e nY 9Y #4:x be iex � e * **** • ** ******* c****** ** ****** Permit Fee $ 17 + 17 4I 7 -51 CCF $ CO /CC Technology Fee $ Zoning $ Structural Review. $ Total Fee Now Due $ . See Reverse side - Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 ch occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be v and a reinspection fee will be charged. Signature The foregoin day of k NOTARY PUBL Sign: Pr in (Revised 02/08/06) State Owner or Ag 1. nstrument was acknowledged before me this /J 3 , 200., by [ lea . e who is personally known to me or who has produced My Commission Expires: APPLICATION APPROVED B: \ As identification and who did take an oath. Signature ** **** * * * * *** ** * *****w* Sign: Print: Zip Contractor The for oing instrument was acknow edged before me this 0 day of , 2 P 9 , by AY/ ("1) who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBL 0 DO 180394 My Commission Exp * w xw* wwwww*9ese ** *1:** ****** ***wwwwwx Plans Examiner Engineer Zoning O H R CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Vilbrun Lalanne PROPERTY ADDRESS: 190 NE 91 St Miami, FL 33138 LOT: 11 PROPERTY ID #: 11- 3101 - 019 -0080 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SYSTEM DESIGN AND SPECIFICATIONS SPECIFICATIONS BY: Astrid V Edwards APPROVED BY: DATE ISSUED: 08/10/2009 BLOCK: 7 SDBDIVISION: SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL. AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. T [ 1,050 ] GALLONS / GPD Septic CAPACITY A [ ] GALLONS / GPD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] N [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 500 ] SQUARE FEET SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [X] TRENCH [ ] BED [ 3 N F LOCATION OF BENCHMARK: FFE: 11.05' NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 18.00 ] [) INCHES I FT ] [ ABOVE A BELOW b BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 48.00 ] [ I INCHES c FT ] [ ABOVE 4 BELOW b BENCSMEP,A /REFERENCE POINT L D FILL REQUIRED: [ 0.00 ] INCHES 1.-Install a 1050 gal min. category-3 septic tank with an approved filter. 2.-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E- 6.013(3)(f), FAC. 3.- Install 500 sf of drainfield in trench configuration. 4. -Invert elevation of drainfield to be no less than 7.55' NGVD. 5. -Bottom of drainfield elevation to be no Tess than 7.05' NGVD. 6. -An abandonment permit for the existing septic tank is required prior to final inspection approval. Astrid V Edwards DH 4016, 10/97 (Previous Editions May Be Used) v 1.1.4 AP931306 EXCAVATION REQUIRED: [ 30.001 INCHES TlTLE Engineer Specialist II [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] TITLE: Engineer Specialist II EXPIRATION DATE: 02/10/2011 PERMIT #: 13-SC-997564 APPLICATION # : AP931306 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR781688 Dade CHD Page 1 of 3 NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statues. Such proceedings are govemed by Rule 28 -106, Florida Administrative Code. A petition for administrative hearing must be in writing and must be received by the Agency Clerk for the Department, within twenty -one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN # A02, Tallahassee, Florida 32399 -1703. The Agency Clerk's facsimile number is 850 -410 -1448. Mediation is not available as an altemative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a 'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. APPLICANT: Vilbrun Lalanne STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Abandonment PROPERTY ADDRESS: 190 NE 91 St Miami, FL 33138 LOT: 11 PROPERTY ID #: 11- 3101 - 019-0080 BLOCK: 7 SUBDIVISION: SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ A [ N [ R [ R SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: ] GALLONS / GPD CAPACITY ] GALLONS / GPD CAPACITY ] GALLONS GREASE INTERCEPTOR CAPACITY [M XIMUM CAPACITY SINGLE TANK:1250 GALLONS] ] GALLONS DOSING TANK CAPACITY [ ]GALLONS 8[ ]DOSES PER 24 HRS #Pumps [ ] D [ ] SQUARE FEET SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH I ] BED I 3 N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ ]I / 1 [ ABOVE/BELOW 3BENCHMARK/REFERENCE [ AB POINT E BOTTOM OF DRAINFIELD TO BE [ ]I / 3 [ ABOVE / BELOW]BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ ] INCHES O Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The T tank shall be filled with clean sand or other suitable material, and completely covered with soil.Have the system inspected H by the health department after it has been pumped and ruptured but before it is filled with sand and covered. E RO N •SPINA v 1.1.4 TITLE: -Lega AP931307 5E -1 PERMIT #:13 -SC- 997565 APPLICATION #:AP931307 DATE PAID: FEE PAID RECEIPT #: - DOCUMENT #: PR781034 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] Dade CHD N °spina 08/03/2009 EXPIRATION DATE: 11/01/2009 DB 4016, 10/97 (Previous Editions May Be Used) Page 1 of 3 NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statues. Such proceedings are govemed by Rule 28 -106, Florida Administrative Code. A petition for administrative hearing must be in writing and must be received by the Agency Clerk for the Department, within twenty -one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN # A02, Tallahassee, Florida 32399 -1703. The Agency Clerk's facsimile number is 850 -410 -1448. Mediation is not available as an altemative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a 'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are govemed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. Atdpe STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number gP.l� / (c Iko-• � n� o� ��� � , s 3iv �� s �. 9o � i 0 591 $' u.iuiiuiiiIiiiiiIIIIIIIIIIIUII 11 1ii11111111II11111 INNIIIIIIII MEMMMOMMINIMMUMEMMOMMMOM OMMUMMOMMUMMINIMMMUMMOMM u o..r twa.44A),_e_ t,,ler w a-o aa.om) � S t *s. YZ Notes: Site Plan submitted by: Plan Approved By (re ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10196 (Replaces HRS -H Form 4016 which may be used) (Stock Number: 5744 - 002 - 4015 -6) Title Date County Health Department Page 2 of 4 CONSTRUCTION PERMIT FOR: APPLICANT: Vilbrun Lalanne PROPERTY .ADDRESS: 190 NE 91 St LOT: 11 PROPERTY ID #: 11- 3101- 019 -0080 SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ ] GALLONS / GPD CAPACITY A [ 1 GALLONS / GPD CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAP_.,ACITY-. AXM- CAACITY SIMILE T 1K:125D S] K ( ] GALLONS DOSING TANK CAPACITY [ ]GALLONS ®[ ]DOSES PER 24 HRS Pumps [ ] D [ ] SQUARE FEET SYSTEM R [ ] SQUARE FEET SYSTEM TYPE SYSTEM: [ ] STANDARD [ ] FIND [ ] MOUND [ ] A I N I E L D 0 T 5 E STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONFIGURATION: [ ] TRENCH [ 3 BED ( l LOCATION OF BENCHMARK: ELEVATION OF PROPOSED SYSTEM SITE BOTTOM OF DRAINFIELD TO BE FILL REQUIRED: R SPECIFICATIO OST?:S Abandonment., Miami, FL 33138 BLOCK: 7 SUBDIVISION: DH 4016, 10/97 (Previous Editions May Be Used) v 1.1.4 ] [ / ][ABOVE/BELOW 3BENCEMARK/REFERENCE POINT / ][ABOVE/ BELOW)BENCHMARK /REFERENCE POINT ] [ [ 0.00] INCHES EXCAVATION REQUIRED: [ PERMIT #: 13-SC-997566 APPLICATION 0 M9 DATE PAID: ] INCHES 308 FEE PAID: RECEIPT #: DOCUMENT #: PR781035 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The tank shall be filled with clean sand or other suitable material, and completely covered with soll.Have the system inspected by the health department after it has been pumped and ruptured but before it is filled with sand and covered. APPROVED B o N vepi.Da DATE ISSUED: 08/03/2009 EXPIRATION DATE: 11/01/2009 Page 1 of 3 AP931308 SE -1 STATE OF ,FLORIDA DEPARTMENT OF HEALTH APPLICATION 'FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT L Permit Application Number 4 . ----- PART II - SITEPLAN cafe: - -Each block represents 10 feet and 1 inch = 40 feet. '10 Q C. , ALL CHANGES MUST BE APPROVED BY THE - COUNTY HEALTH DEPARTMENT D1-14015,1 0/96 (Replaces HRS -H Form 4016 which may be used) (Stock Number. 5744-002 -4015 -6) — f � 6 3� (t - Title Date County Health Department Page 2 of 4 NOTICE OF COMMENCEMENT 1 111111 11111 11111 11111 11111 11111 11111 1111 111 A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPEC11011 CFP43 20:119R058:18 1 p -3 OR k 26975 Ps 3565; Ups: PERMIT NO. AP TAX FOLIO NO. RECORDED 08/12/2009 14:23:37 HARVEY RUVIN, CLERK OF COURT MIAMI-DADE COUNTYr FLORIDA LAST PAGE STATE OF FLORIDA: COUNTY OF MIAMI-DADE: - STATE G' NEU° THE UNDERSIGNED hereby gives notice that improvements will be 15 , stew property, and in accordance with Chapter 713, Florida Statutes, the follow info is provided in this Notice of Commencement HARVEY itt ivi;s; • 1. Legal description of property and street/address: t * 1) 9/ Sr .5 - 2- Pi, 351 gcr- rt4=-14- to 2. Description of improvement: I # t,tt A./. 3. Owner(s) name and address: t 21 .57/_3k Interest in property: ibUni Name and address of fee simple titleholder: 4. Contractor's name and address: 9. Expiration • different da Notary Public Print Notary's My commission expires: 123.01-52 PAGE 4 5/06 A- it) /We. 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond 6. Lender's name and addreqs: I p 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1) )7., Florida Statutes, '- Name and address: A/ /V • s' Seazik f'2 en; fft, 3,�z1 /I ., . 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's . Notice as provided in Section 713.13(1)(b), Florida Name and address: Al drJ , ...7 /i it___147_2___1911.) 7 ef,-.. frft ei.fil ; FL sywz. ate of jL otice of Commencement: (the expiration date is 1 year from the date of recording unless a Signatu : of 0 er Print 0 ner's Name 1 64 LA 1 AO Pe.: Prepared by Swo to and subscribed re rne, his ,L..day of A\A- , 20M/ Addressa7 /71 4. ah" if- 5e02. O T a R APPLICANT: Vilbrun Lalanne STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS New PROPERTY ADDRESS: 190 NE 91 St LOT: 11 PROPERTY ID #: 11- 3101 - 019 -0080 SYSTEM DESIGN AND SPECIFICATIONS I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: [ 0.00] INCHES Astrid V Edwards Astrid V Edwards 08/10/2009 Miami, FL 33138 BLOCK: 7 SUBDIVISION: [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL. AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. T [ 1,050 ] GALLONS / GPD Septic CAPACITY A [ ] GALLONS / GPD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 500 ] SQUARE FEET SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [R] TRENCH [ ] BED [ 3 N F LOCATION OF BENCHMARK: FFE: 11.05' NGVD [ 18.00 ] [) INcaas I FT ] [ ABOVE A BELOW U BENCHMARK /REFERENCE POINT [ 48.00 ] [) INCHES I FT ] [ ABOVE 4 BELOW b BENCHMARK /REFERENCE POINT EXCAVATION REQUIRED: [ 30.00] INCHES 1.- Install a 1050 gal min. category-3 septic tank with an approved filter. 2.-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E- 6.013(3)(f), FAC. 3.- Install 500 sf of drainfield in trench configuration. 4.-Invert elevation of drainfield to be no less than 7.55' NGVD. 5. -Bottom of drainfield elevation to be no less than 7.05' NGVD. 6.-An abandonment permit for the existing septic tank is required prior to final inspection approval. TITLE: Engineer Specialist II TITLE: Engineer Specialist II DH 4016, 10/97 (Previous Editions May Be Used) v 1.1.4 AP931306 . SE794100 APPLICATION #: AP931306 EXPIRATION DATE: 02/10/2011 19j PERMIT #: 13-SC-997564 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR781688 Dade CHD Page 1 of 3 NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statues. Such proceedings are govemed by Rule 28 -106, Florida Administrative Code. A petition for administrative heart ng must be in writing and must be received by the Agency Clerk for the Department, within twenty -one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN # A02, Tallahassee, Florida 32399 -1703. The Agency Clerk's facsimile number is 850 -410 -1448. Mediation is not available as an alternative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a 'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ ] GALLONS / GPD CAPACITY A [ ] GALLONS / GPD CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] • [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ ] SQUARE FEET SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [] MOUND [ ] I CONFIGURATION: [ ] TRENCH [ ] BED [ 1 N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ ] [ / ][ABOVE/BELOW 1BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ ][ / ][ ABOVE/ BELOW3BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES 0 T H E R STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM! CONSTRUCTION PERMIT FOR: OSTDS Abandonment APPLICANT: Vilbrun Lalanne PROPERTY ADDRESS: 190 NE 91 St LOT: 11 PROPERTY ID # : 11- 3101- 019-0080 Miami, FL 33138 BLOCK: 7 SUBDIVISION: v 1.1.4 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] EXCAVATION REQUIRED: [ ] INCHES Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The tank shall be filled with clean sand or other suitable material, and completely covered with soil.Have the system inspected by the health department after it has been pumped and ruptured but before it is filled with sand and covered. SPECIFICATIONS BY: +.RO N •SPINA T : - Legacy APPROVED BY: � TITLE: 17 Dade CHD N Oepina DATE ISSUED: 08/03/2009 EXPIRATION DATE: 11/01/2009 DH 4016, 10/97 (Previous Editions May Be Used) Page 1 of 3 AP931307 sE -1 PERMIT # : 13 -SC- 997565 APPLICATION # : AP931307 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR781034 NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statues. Such proceedings are govemed by Rule 28 -106, Florida Administrative Code. A petition for administrative hearing must be in writing and must be received by the Agency Clerk for the Department, within twenty -one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN # A02, Tallahassee, Florida 32399 -1703. The Agency Clerk's facsimile number is 850 -410 -1448. Mediation is not available as an alternative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a 'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are govemed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. !I� f /& M //1 PAR II - SITEPLAN` Scale: Each block represents 10 feet and 1 inch = 40 feet. . E- 1 M mic 111111111iiiikM 111111111.11111111 NI HMI 111111111111111 rAg kinummma mom= immisammummonammiiimpummpum 11111111111111111111 vt_ 10(.4 s 00- Notes: (9"4"T- to- C Site Plan submitted by: Plan Approved By STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number Signature Not Approve I/ Title ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS -H Form 4016 which may be used) (Stock Number: 5744 - 002 - 4015 -6) Date County Health Department Page2of4 CONSTRUCTION PERMIT FOR: OSTDS. Abandonrnel t. APPLICANT: Vilbrun Lalanne PROPERTY ADDRESS: 190 NE 91 St Miami, FL 33138 LOT: 11 PROPERTY ID #: 11- 3101 - 019-0080 SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ A [ N [ K [ D [ ] SQUARE FEET SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [ ] BED I 3 N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: 0 T H E Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The tank shall be filled with clean sand or other suitable material, and completely covered with soil.Have the system inspected by the health department after it has been pumped and ruptured but before it is filled with sand and covered. R SPECIFICATIO STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM ] GALLONS / GPD ] GALLONS / GPD ] GALLONS GREASE INTERCEPTOR CAPACITY ] GALLONS DOSING TANK CAPACITY APPROVED B o N oepina DATE ISSUED: 08/03/2009 BLOCK: 7 SUBDIVISION: [ 0.003 INCHES EXCAVATION REQUIRED: [ DH 4016, 10/97 (Previous Editions May Be Used) v 1.1.4 CAPACITY CAPACITY [MAXIMUM - CAPACITY SINGLE TANK:1250 GAMMONS] ]GALLONS ®[ ]DOSES PER 24 MRS #Pumps [ 1 AP93130B FEE PAID: RECEIPT #: DOCUMENT #: PR781035 PERMIT #:13-SC-997566 APPLICATION #4d3931308 DATE PAID: [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] / 1 [ABOVE / BELOW] BENCHMARK /REFERENCE POINT / ][ABOVE /BELOW] BENCHMARK /REFERENCE POINT 3 INCHES SE - 1 EXPIRATION DATE: Dade CHD 11/01/2009 Page 1 of 3 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number - PART II - S ITEPLAN - - - - - 7 ,53,2- --- - - - - -- Scale: Each block represents 10 feet and 1 inch = 40 feet. — (0 ""t, ) I4oi ; VTAU ) C s-1- c e.) t) t Site Plan submitted by ` ,9- Not Approve • Plan Approved _° _ By DH 4015, 10/96 (Replaces HRS -H Form 4016 which may be used) (Stock Number: 5744- 002- 4015 -6) ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT Title Date County Health Department Page 2 of 4 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME FI INSpEcilfly Q� q ® , 0-110-6 PERMIT NO. r ' i' �g> 13 TAX FOI..1O N e, / 1/ 4. Contractor's name and address: / fia C Se A. 12O l; al Seal. , of C1r of t .,,tJrts D.C. a 1 c 1. ma i STATE OF FLORIDA. COUNTY OF MIAMI -DADE: STATE EE< THE UNDERSIGNED hereby gives notice that improvements will be property, and in accordance with Chapter 713, Florida Statutes, the followin is provided in this Notice of Commencement. 1. Legal description of property and street/address: 2. Description of improvement: 3. Owner(s) name and address: Interest in property: Name and address of fee simple titleholder: . / "- 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond$ 6. Lender's name and address: Swo to and subscribed Notary Public Print Notary's My commission expires: 123.01 -52 PAGE 4 5#0O 7. Persons within the state of Florida designated provided by Section 713.13(1 ) )7., Florida Sta Name and address: MIN ..' flip f!,,r;: HARVEY RU'/t'i, gY . ` g ee 0lc- 9. Expiration different da Signatu = of 0 er ` . Print O .ners Name )T ` 6_ -- Prepared by day of , 20 Addr 1 IH111 0111 11111 11111 1111111111 11111 1111 111 CIF 2009R058!081 DR Sk 2685 Ps 3565i (fps) '. RECORDED 0S/12/2009 14 :23:37 HARVEY RUVIHy CLERK OF COURT MIAMI -DADE COUNTY, FLORIDA LAST 'PAGE by Owner upon whom notices or other documents may be served as of the Lienor's Notice as provided 8. In addition to himself, Owners designates the following person(s) to receive a copy in Section 713.13(1)(b), Florida tatutes. p Name and address: L 4/ otice of Commencement: (the expiration date is 1 year from the date of recording unless a