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SEPTIC TANKData vv • 0? Job Address Legal Description Owner /Lessee/Tenet Owner's Address ) Contracting Co. PJR1VIT APPLICATION FOR MIAMI SHORES VILLAGE 100 N.E. 22d Aven:ie• Miami Shores, Florida 33138 • 305-795-2204 7 t)6 ?7s2 _ _ Address Qualifier 1 .1 Phone cg K U / State # 1 Municipal # T 1/KCompetency # Ins. Co. Tax Folio // 3 �/ o ( / ooJ L/ Historically Designated: Yes No Master Permit # Phone IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHE ' ► ' ECTION. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING WORK DESCRIPTION: (� i 6fii0d0A) o / � t Square Ft. Estimated Cost (value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for all disciplines. 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. Furthermore, I authorize the above named contractor to do the work stated. Signature of owner and/or Condo President Date FP" ,-,?, 22 ) 'o), Date ary as to ontractor ► . : Ownei r �� -' ` c .,r;r� ' '. 3O w 8 r nuvrii ad 6� bate j t, '� Commission Expires � , v . y , Q CC7 86697 .- �" ' 4 ' <4 MY CO.^JIYISSIONEXPIRES OF F� NOV. 15,2002 \ ©' RADON C.C.F NOTARY S-, O 0 BOND TOTAL DUE 5--, 0 0 Building Electrical \ Plumbing Structural Engineer Notary as to Owner and/or Condo President My Commission Expires My p Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 3/5/2002 Applicant: JOHN Owner: WYATT Contractor BOBS SEPTIC & DRAIN INC Address: 1020 NE 130 ST Local Phone: Cellular: Parcel # 1132060190050 Job Address: 440 NE 91 ST Fees: Description Amount FEE2002 -1305 Building Fee $90.00 CI FEE2002 -1306 Notary Fee $5.00 Total Fees: $95.00 Permit Status: Approved Permit Expiration: 9/1/2002 Construction Value: $4,100.00 Work: PUMP & ABANDON SEPTIC TANK ONLY If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection is $50.00, which must be p . „ �,. . , � - y,. .: .— _..::cAr __- ,2 .,: , . , - 7 , 1 , ... - . W - Q This Permit is granted to the contracts —� �rdihances pertaining ther to and with ti and - approved by the prop n I authorization. A further c V 1 ordinances and regulation /by his agent -ry ' Signed: In considerati with the plans, myself, my agent Signed: . s or o t iss ance to me wings, statements or r employes r municipal al dition upon v pertaining to mployees. h.. PAY TO THE ORDER FOR ctibank CITIBANK, F.S.B. BR. N37 2750 AVENTURA BOULEVARD AVENTURA, FL 33180 Plumbing Permit Permit Number: PL2002 -61 WYATT JOHN Legal Description: EL PORTAL PB 9 -101 LOT 7 & E1 /2 OF LOT 8 BLK 1 LOT SIZE 75.000 X BOB'S SEPTIC & DRAIN, INC. 1020 NE 130TH ST. PH. 305 -558 -5818 NORTH MIAMI, FL 33161 -4211 I' /, 8/9- � L or l m , �v1 2�'S / L $ 6 3, ---- 1 01 4 /[ C7.'l f X 2F C-- DOLLARS XV 11'005X0611' I:26601365541: Page 1 of 1 Total Fees: $95.00 Total Receipts: $95.00 DATE c/?-LO g- 5106 63- 865537 2660 M' Square Ft. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 7955- 2 / J� u q / Sr Tax Folio �l - 3 O' � j V 00 SO Job Address Legal stion 7 7 S a h El w171-p1 Historically Designated: Owner /Lessee/Tenetl B 4 bga ' A 14) y k V u�) r\ Owner's Address ( ` �'' ,L)62, l/]' Contracting Co. Qualifier State # n Q ') F7/ Permit Type (circle one): BUILDING ELECTRICAL WORK DESCRIPTION: Master Permit # Yes No aaaa Phone je ss /ba b Lir 1 Sr, Phone c S? Municipal # 1l Competency # l 1 1 Ins. Co. IF, THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. PLUMBING s Th6tA lvtuq MECHANICAL ROOFING g �s WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for all disciplines. OWNERS AFFIDAVIT: 1 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. Furthermore, I authorize the above named contractor to do the work stated. re of owner and/or C d j Presid fr . Date I � • A 4. • Si • t.r of Contra• r • , , r / 40' • ' .. • 0 14, wner Bui er NOT a? Sign Notary as to 0 er an My Commission Expir' d/or_� on'o- ' r - siden •- S 1 P n 6 ARC:: ej . 0 OF f■PcL NOV. .i ce__ RADON C.C.F 3 . O C) NOTARY S . 0 ?) BOND 3 / FEES: PERMIT APPROVED: Zoning Building Mechanical Plumbing oA Date Al tv as • Contra• • .'or,Aw r Bui dercy: '= ` My Commission Eicpife w'- " d CC 7ar,6` " / OF f �0 NYC ? TOTAL DUE 3' 43 o V Date ate Electrical Structural Engineer NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. //- 3 d - 0 / q - oo - o STATE OF FLORIDA: COUNTY OF DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713. Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property 1.--0 erty and street address: 1.--0 7 5O6 D / 1 ) i 5 ,i ) OkJ c C, pop. /6L 4'4 o c ( 5 rri nor l , mil, 1 2. Description of improvement: 3. Owner(s) name and address: O h I t J + R .b E 1 p l i - - Interest in property: Name and address of fee simple titleholder: 4.- Contractor's name and address: go • ifl &- , 33 16( 6. Lender's name and address: Print Owners Name Notary Public Print Notary's Name 5. Surety :(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ My Commission Expires: Signature of Owner E bC.(1 - i 1 tit}ik t1 Sworn to and subscribed before me thisZ IP day of ,.., , 2 R 12 10 16 2002 FEB 28 12:55 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)(a)7., Florida Statutes, Name and address: .� 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) Prepared by: ♦P U e< ANG_LA M O \14^'1: - i C COMMISSION UV.C.C1 ct- MY OF F\-O NOV. IS,-0 123.01.52 2/93 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT • CONSTRUCTION PERMIT FOR: [ X ]New Syster:- [ ]Existing System [ ]Holding Tank [ ] Innovative Other [ ]Repair ]Abandonment [ !Temporary [ NA ] APPLICANT: Wyatt, John & Rebecca AGENT: OWNER, PROPERTY STREET ADDRESS: 440 NE 91 St Miami FL 33138 LOT: 7 BLOCK: SUBDIVISION: El Portal [Section /Township /Range /Parcel No.] PROPERTY ID #: 11- 3206 - 019 -0050 [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E- 6,.FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. 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 PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T [ 900 ]Gallons SEPTIC TANK A [ 0 ]Gallons MULTI - CHAMBERED /IN SERIES: [Y ] N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ] GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS 0 ] D [ 429 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 jSQU=.RE FEET SYSTEM A TYPE SYSTEM: [ Y ]STANDARD [ N 1FILLED I CONFIGURATION: [ N ]TRENCH [ Y ]BED N F LOCATION TO BENCHMARK: 8.48'NGVD Cl NE 91 St & W P1 I ELEVATION OF PROPOSED SYSTEM SITE [ 3.4 ] [ INCHES ] [ BELOW]BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 32.2 ] [ INCHES ] [ BELOW]BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 30.0 ] INCHES OTHER REMARKS: [SE] Sleeve potable water lines within 10 feet of drainfield. Potable water lines may not be installed within 2 ft of drainfield. Install 900 gls. new, multi - chambered s/t equipped w/ an approved filter. Install 429 sq.ft. d/f using the existing suitable soil, previous confirmation of that condition in the complete area, plus 1.0'width around the perimeter to 72 "depth from the existing grade The existing s/t shall be pumped, crushed the bottom, filled w/ suitable soil and provided the pump out receipt. Invert elev. of d/f no less than 6.30'NGVD Bottom of d/f elev. no less than 5.80'NGVD SPECIFICATIONS :Y: RAM, APPROVED BY:. DATE ISSUED: 2/2 Z-1 U Z r ] o:, TITLE: DH 4016, 03/97 (Obsoleces previous editions which may not be used) (Stock Number: 57(4- 001 - 401 -0) oscds - : i CENTRAX #: 13 -SG -11627 DATE PAID: FEE PAID : $ RECEIPT OSTDSNBR : 02 -0234- -N MULTI - CHAMBERED /IN SERIES: [Y ] [ N ]MOUND [ N ] [ N ] TITLE: Engineer . 111.- Dade.r2/ EXPIRATION DATE: ? I 2 L H fl 0 3 Page _ of 2 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION'AND SYSTEM SPECIFICATIONS APPLICANT: Wyatt, John & Rebecca AGENT: , OWNER LOT: 7 BLOCK: SUBDIVISION: El Portal ID #: 11- 3206 - 019 -0050 TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVTr)R REGTSTRATTON NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMTTTAT,. C aT,T 1-,EMS. PROPERTY SIZE CONFORMS TO SITE PLAN:[X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.23 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [64E -6, TABLE 1] AUTHORIZED SEWAGE FLOW: 575 GALLONS PER DAY [1500GPD/ACRE OR 2500GPD /ACRE] UNOBSTRUCTED AREA AVAILABLE: 860 SQFT UNOBSTRUCTED AREA REQUIRED: 857 SQFT BENCHMARK /REFERENCE POINT LOCATION: 8.48'NGVD Cl NE 91 St & W P1 ELEVATION OF PROPOSED SYSTEM SITE IS 3.36 [ INCHES ] [ BELOW ]BENCHMARK /REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER: N/A FT DITCHES /SWALES: N/A FT NORMALLY WET? [ ]YES [ X ]NO WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: N/A FT NON - POTABLE: N/A FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 10 FT SITE SUBJECT TO FREQUENT FLOODING: [ ]YES [ X ]NO 10 YEAR FLOOD ELEVATION FOR SITE: 0 FT NGVD SOIL PROFILE INFORMATION SITE 1 Munsell # /Color Texture Depth 1OYR - 1/1 - RN T.namy Sand n to 77 to to to to to to to USDA SOIL SERIES: 10 Udorthents, OBSERVED WATER TABLE52.00 INCHES [ BELOW ] EXISTING GRADE TYPE: [ PERCHED ESTIMATED WET SEASON WATER TABLE ELEVATION:52.00 INCHES [ BELOW ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: 0.0 INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING:Replacement /0.70 DEPTH OF EXCAVATION:30.0 INCHES DRAINFIELD CONFIGURATION: [ ]TRENCH [ X ]BED [ ]OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA: Sleeve potable water lines within 10 feet of drainfield. Potable water lines may not be installed within 2 ft of drainfield. SITE EVALUATED BY: Rolando Arrieta DH 4015, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 003 - 4015 -1) [ostds eval 4015 -3] CENTRAX 4: 13 -SG -11627 OSTDSNBR : 02- 0234 -N OWNER 10 YEAR FLOODING? [ ]YES [ X ]NO SITE ELEVATION: 0 FT NGVD SOIL PROFILE INFORMATION SITE 2 Munsell # /Color Texture Depth 1 ()YR- S /S -i1 RN T.namy Sanri () to to to to to to to to USDA SOIL SERIES: 10 Udorthents, DATE: 2/5/02 Page 3 of [vl [ ] APPLICATION FOR: New System Repair PROPERTY SIZE: 0. Z3 STATE OF FLORIDA . DEPARTMENT.OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT [ ] Existing System [ ] Abandonment BUILDING INFORMATION [ ✓] RESIDENTIAL Unit Type of No Establishment 2 3 4 [ ] Floor /Equipment Drains [ [ ] PROPERTY INFORMATION DF I 7 4 -r w LOT: BLOCK: 4 SUBDIVISION: E L- Po [ 2. T 6c4- [ ] Other (Specify) Holding Tank Temporary [ ] COMMERCIAL 3 � 900 ,4 /A VI PERMIT NO. 0 WIMP FEE DATE PAID: „ IMP FEE PAID: I( (-3 • • /-# III W t [ ] Innovative [ ] APPLICANT: 1■4 et, wpb €CCA 1 5.1- - 534 9062 fd A- AGENT: .1 INN/I i■-)C.0 — N't( Lex— TELEPHONE MAILING ADDRESS: 440 4 C S -A1A2L.,1 A 24 q_ het LAM f .14 FL 33141 TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489.105(3)(m) OR 489.552, FLORIDA STATUTES. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE DOCUMENTATION OF THE DATE THE LOT WAS CREATED OR PLATTED (MM /DD /YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. PLATTED: t 6 9 -tot PROPERTY ID #: I ZO tp -Qi ci -005o ZONING: I•17 I/M OR EQUIVALENT: [ Y (/10441,4 •4t'9 Rt:2 n Omc-) ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [ V] 2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y /( NJ] DISTANCE TO SEWER: Who, FT PROPERTY ADDRESS: 440 t• 9 t er. t { -b2 _ P L. 3 3 [ 3 a / /DIRECTIONS TO PROPERTY: 2 Co a.sr - `ol'1 5 O t -H )C{ typ up -p o502. malt a n g l anitd Littei, u)6041_ Rm. 114 kAvit c _ No. of Building Commercial /Institutional System Design Bedrooms Area Sqft Table 1, Chapter 64E -6, FAC (t ?q(, 2 Peorakto ter , ) DATE: DH 4015, 10/97 (Previous Editions May Be Used) Page 1 or 4 Job Bush Governor Chapter 64E- 6.004(3)(a), F.A.C.: ffUL, James J: James, M.D., Dr. P.H.,M.HA, Director "WELL FORM" A plan or plat of the lot of total site ownership drawn to scale, showing boundaries with dimensions, locations or residences or buildings, swimming pools, recorded easements, the on -site sewage disposal system location, the general slope of the property and any existing or proposed wells, drainage features, filled areas, obstructed areas, and surface waters such as lakes, ponds, streams or canals. The location of wells, on -site sewage disposal systems, surface waters and other pertinent facilities of features on contiguous or adjacent property, if the features are within 75 feet of the applicant lot, mast also be shown but need not be drawn to scale. The location of any public potable water system well, as defined in Chapter 64E- 6.002(40)(6), within 200 feet, and the location of limited, non - community or other public wells, as defined in Chapter 64E- 6.002(40)(b), within 100 feet of the applicant lot must also be shown, or as defined in Chapter 64E- 6.002(4)(a), F.A.C., within 75 feet from a private potable water well (well used only by four or less non - rental residences). Chapter 4616.1(p) South Florida Building Code: Wells shall be located as to be free of contamination from unsafe water supply and shall be at least 100 feet from a septictank, drainfield, soakage pit or discharge well.... = = Under Chapter-64E -6, F.A:Cr nderdrains connected to a drainagesystem are considered.,,.. eztensioed itrrftce; witer; 'Thc•minimum-setback for lots platted -prior to January• 1, ,,, _3x-.. 1991 is 50 feet. The minimum setback for lots platted on or after January 1, 1972 Is 75 feet. � ..tW her e .solid - . pipe' is used. to connect to:..an existing atormwatct.jy.$ten4.1114__. setbacks would be applicable only to the underdrains, not the solid pipe. I have read the above and to the best of my knowledge I have provided the Department with fall infonnation.regarding pertinent facilities and features on all.adjacent properties. • Furthennore,-I understand__ that -any Septic Tink Construction Permit issued on the basis . of aald facilities and features as provided by meind found to be incorrect will be subject to - i revocation in accordance withrthe provisions of Chapter120, Date: I ( OZ_ DOH# Signature: Sunk Finale, MS, PE , Eavttontmamd Mmlalstrstor Mlatald?sde County Health De pacmuatlFnv1 o u c ntal Health 1725 N.W. 167 Strad, Miival F1od& 33056 TEL (305) 623 -3500 • FAX (305) 627 -3502 Email: tunic elmir®ddutste.A.us Wobsite: vnvw.dadeivalth.ocg Robert G. Brooks, M.D. Secretary APPLICANT: AGENT: PROPERTY ADDRESS; FILL [ [ [ [25] [26] STATE. OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DIPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL 1„-‹: LOT: - 2 BLOCK: SUBDIVISION: ,�' : 7,- - -7 /r � - -- ==== ========= =ass= -= ======z =======som=a_= CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION [01] TANK SIZE [1],7,t) [2] (021 TANK MATERIAL f [03] OUTLET DEVICE [04] MULTI - CHAMBERED [[_Y %/ N ] . [05] OUTLET FILTER 2 a) • [ 06 ] LEGEND P-Al!, /C' '/L 4 : e (07] WATERTIGHT [08] LEVEL °' .. [09] DEPTH TO LID„ '" DRAINFIELD' INSTALLATION - [10] [11] [12] [13] [14] [ / EXCAVATION MATERIAL FILL AMOUNT A 9 a' FILL TEXTURE. ---° EXCAVATION DEPTH AREA REPLACED REPLACEMENT MATERIAL . L EXPLANATION OF VIOLATIONS / REMARKS: [ ] [ 1 [ l BM [ 1 [ [. AREA [1 CT [2) / 5 SQFT DISTRIBUTION BOX _ HEADER [ NUMBER OF DRAINLINESI % f [ DRAINLINE SEPARATION( [`' DRAINLINE SLOPE DEPTH OF COVER '/ 4 [16] ELEVATION [ABOVEfBELOW] [17] SYSTEM LOCATION [18) DOSING PUMPS [19] AGGREGATE SIZE A$, [20] AGGREGATE EXCESS Ve.F1NES [21] AGGREGATE DEPTH / n l 1 1 1 1 1 [ l [ l SETBACKS SURFACE WATER 4 / , DITCHES A/ )f ' PRIVATE WELLS AJ Job. [ [28] [29] [30] [31] [32] [33] [ [35] WRONG DEM:0MM _ PROPERTY ID 1: PUBLIC WELLS N / FT IRRIGATION WELLS , 0 ■ d FT, POTABLE WATER LINES. ,- ;;;FT 5 BUILDING FOUNDATION �-' FT PROPERTY LINES i FT OTHER FT FILLED / MOUND SYSTEM [36] DRAINFIELD COVER [37] SHOULDERS [38] SLOPES [39] STABILIZATION ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA [41] STORNWATER RUNOFF [42] ALARMS . [43] MAINTENANCE AGREEMENT [44] BUILDING AREA [45] LOCATION CONFORMS WITH [46] FINAL SITE GRADING [47] CONTRACTOR [48] OTHER r‘,/ PERMIT NO.02 °' /l/ DATE PAID: / FEE PAID: -Z( i i - ; , (7r. RECEIPT 1 I 0 x') /' S >: "C ABANDONMENT [49] TANK PUMPED Li /y [50) TANK CRUSHED & FILLED _ Z//_. FT FT FT SITE PLA)I j1- [ l CONSTRUCTION [APPROVED' /,DISAPPROVE : ,� i --",. , - 1,92 / ),-, .ti CHD DATE:2 - 1, -r i FINAL SYS.N [APPROVED /DISAPPROVED] : ,/i..... , 1,-1 /; ' (i . A ) ) ,. CHD DATE:2 -' 02 z. DH 4016, 10/97 (Pre e ous Editions May Be Used) Page 2 of 3 V 3DCM SMM l'--r H DEPARTMENT rC. HE ulCc MS I'�. 0-0Y _ �:3.\1 ; p/U '�.-.,,., , r� N RG I1�ar j "��1� o " \/'' T /� ... ..�. 'l'J V�;N6�WN' � ��LGo��7 NOT :.A. .. � .. ��.�.�: J�/u L'l L � V��JVCJ�II�IV'Lv �. �'�J ��;: �4�w�� AND ` L RULE. 9 1U ORMAITON C©CY!:PLLE TE LJ RY © ! '_: C O^: =7.X0 n.Tz S: MATER (c©, Vtaanss, etc) FLTE R (mcm ifaoturer, rr Eke, modQ LEGEND (manEtemluTQP =de) D NAC[G ELD AMEA (swam) ffest) D :Sb RC iTOO I C OX / HEADE (heck too* CND MDER OFD AC( UNE8 (m1umbar Cystalle J) SYSTEM L L!VATCOG' (m rQCattion to BM) DOSONG PUMPS (numC r kIst el) g ` BAC S (moor 7 E md setbacks of R) S" 'DACCXS OT�� G°3 (Es requir STJAMCLCAMN (date olablOized) cevr ACCToR (c ontrEctor hlsttaBhg sy -Awn) ADDM3N . [NFORMATCO (Es regdred) ABANDONMENT TANK PUMPED (gate) TANK ffAus: 7 AmD FCL2 C DD (dee) C /�� 1 . A':� �J VC;.v .� r' '.O � O u C�iwd��� ' Gft�lU E�u.n�� �P, C:�� .>:, -... a � �_"�C.y�r , ETA o P@�M'7 C `'.\�,8 0r� ,, \ ^ O y \ /.ice tij o ! g Y �. �; � ti APPROVAL.: PC,C� £'�;�,�POMgJ @P oJ�.� � ;Cry, _ ��J �,�r�,:.d�:� cno al4o. CM() C pTaMCoi ' Cogs'. ,u:; ., ... , ,,. 'Et.g C.TA dEtA Coifs' ;: "CY . n . rF . r. Mph C' Gl _� ^� r ��,� u��,,, r��U 0 �Pc.�tC� Jfl�,. tGU� C�'n. , 'Jl�� C�'..�. - - -.. , .� . __.. :� ,.,.__,,,.,_ �_ . £:I.'� uC`Z �P�` .m P ';0 pe T P ^0 n p���tPq[}iQ nr , f —;�_Pn ���.�., .n • nal � �� �J � sJ� f'�JuUw�w�LJ �C✓� .,.,�� CJL�uL' ��.�.:) :VA`).!TO.v ia.EVATDM CDs' Ai • r ,� Pi© Ar C©C^9 CC's rsO pro aply cuaVo CQ�£ :: 7 . nC; ' >?tii : :< '000.nactruvo p.00 .: att OF CPC >32 �':C ., o:, J o ' oP Egent. Lot, [ ©c cSR:ji SLIMVa:_"- C. Cs�` ] O GG°3C;;ND C.C. H SH AS NMI' [N8`.A9L,:_,/JTON SKETCH I 0 TOP H SMUT' APPLICANT: , ,4t ' AGENT: t f LOTS STATE FLORIDA DEPARTMENT OF ONBITE SEWAGE TREATMENT AND DIPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL BLOCK :1 /" i' , v f 1 TANK [01] [02] [03] [ [05] [06] [07] [08] [0 FILL / EXCAVATION'MATERIAL [22] FILL AMOUNT ' [23] FILL TEXTURE .[ 24 ] EXCAVATION DEPTH [25]- AREA REPLACED . [26] REPLACEMENT MATERIAL MULTI - CHAMBERED-[ Y /!N ] OUTLET FILTER LEGEND - WATERTIGHT LEVEL DEPTH TO :LID DRAINFIELD INSTALLATION AREA DISTRIBUTION BOX•' HEADER NUMBER - OF DRAINLINES DRAINLINE SEPARATION`, • DRAINLINE SLOPE DEPTH OF COVER - ELEVATION (ABOVE /BELOW) BE SYSTEM LOCATION ' DOSING PUMPS AGGREGATE SIZE AGGREGATE EXCESSIVE FINES AGGREGATE DEPTH - t EXPLANATION OF VIOLATIONS / REMARKS: 1 DE 4016, 10/97 (Previous Editions May Be Used) PROPERTY ADDRESS: . 1 /(.- SUBDIVISION: ( j� !/ INSTALLATION ; TANK SIZE [1] [2 ] TANK MATERIAL .1 OUTLET DEVICE Mill&ONG DEP /U17142OJT SETBACKS [ 1 [ [ -1 [?81. [ 1. [29] [ 1 [30] [ l [31] [. l I 1. I PERMIT 110.0 , o'' DATE PAID: 75 FEE PAID: 1 RECEIPT f: PROPERTY ID #: == s===a == = = == ======s : Wit ======= CHECKED (1) ITEMS ARE NOT IN COMPLIANCE WITH STATUTE--OR RULE AND MUST BE CORRECTED. SURFACE WATER _ DITCHES • PRIVATE WELLS PUBLIC WELLS IRRIGATION WELLS ( ] (32), -POTABLE WATER LINES ? FT [ I [33] .BUILDING FOUNDATION fi FT [ l [341 PROPERTY LINES FT [ ] [35] OTHER FT FILLED / MOUND SYSTEM [36] DRAINFIELD COVER [37] SHOULDERS [38], SLOPES • [39] STABILIZATION ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA (41] STORMWATER RUNOFF [42]. ALARMS 143] MAINTENANCE AGREEMENT [44] BUILDING AREA [45] LOCATION CONFORMS WITH SITE PLAN [46] FINAL SITE GRADING ; y [47] CONTRACTOR. pri i ., v �� : % ' � �•a. r (48] OTHER "/',4:1 ABANDONMENT (49 ] TANK PUMPED [50] TANK CRUSHED i `�'_/L FILLED / c) FT FT FT FT FT CONSTRUCTION [APPROVED /DISAPPROVED): / FINAL SYSTE1. [`[APPROVED /DISAPPROVED] :'. - J7) t. -- CHD DATE ::2 {_ ' ) Page 2 of 3 :M. A_ AODR'' S: SL DDIV SOONI ST'S'." :T OR U .E. CNO SRC ATOOCO OS CCOCOS.'%t C!TCED C3 ODD Bpi` ,:YJS: A X SVE ((t ".Oo ns) AS C�DU Blass. Al TCON SC CH TAN:X CAA ,EROALL (concrete, 'Da OUTT FBL TER (m enugooluPeP, make, modeO) LC C : ZD (,mare {f ©Je) DON BEWDD AREA (square feet) D8S`?R8BUT OON SOX / C=EADER (check box) NU .' '7R OP D' °aONLOCMES (01UPTItZr 6� SYSTEM ELC VATOON (in relation to BM) DOSOINO PUMPS (number ows&ta. •i) SET 3AC KS (record a©IunO settick in 7i) SETDACKS OTHER (Es maqu rr PI) STABOUZAT OLEO (cOnte slanzed) rld CONTRACT SGT ( ©ntrrcaor instElhe system) ADDOTCOC AL C IFORMATO N (as r r l r d) ADANDONMENT SLANGS PUMPED (ate) TANOS ©RUSHED AND G=BLLLEDo (data) BEss, etc) Pro c-2j ®Wwefs g OO u 3 :o. PPOp j omees Csgdk roe sgsaRtEQEio. P.O. kmes1 n c9c :? fc° c :! a ay ELen4. Lot, IO© and SuMivOs.c:: .(kr 27 elErtmter mmmr er ; ;,«lj cY rn8sap OD 0 cr CCU �88�) lA 0 1 0 '6 l Realm] f ' o o n 0 0 �. 1�!`��BC��c C_} C� @Z9�: ��� � �m� ��� r, o� Cs'r_£_� .�,_. �� rr 0��,.,�ti, �`n rc�a: C CIAN As' C:Cr'Cd„e £° opmFI' emJ OF ��, Ha „�,� �'��L: o El1�aJ o nN. A°_`ROVN,. Urea E ;p ®M c'c?o vc yV, r °', otiAd,so off u� „wE:. (gFET: e unK tho cm has ©© af., ” ea) Oo4 graL £:. `._ �>� -. '>stE..tOE: CW,'lll (Ans cal) spec,- aTonts subm!' ..^' >d nitOr, O U E""� rLEVATCOH c 1. XC tiM/ C: r POO CXBS`u'ONO GROUND TOP C SC OCT C .O. c H.B. L�.E• H SHOT °D S! �C `: ELL ;MQ T OON =u. , [( °1 SHOT Village of Miami Shores 0 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305- 795 -2204 Printed: 3/5/2002 0 Applicant: JOHN WYATT O Owner: WYATT JOHN N 3 Contractor BOBS SEPTIC & DRAIN INC Address: 1020 NE 130 ST Local Phone: Cellular: Parcel # 1132060190050 Job Address: 440 NE 91 ST Fees: Description Amount FEE2002 -1307 Buildier's Bond $300.00 ■ FEE2002 -1308 CCF $3.00 Q FEE2002 -1309 Notary Fee $5.00 FEE2002 -1310 Building Permit Application Fe$60.00 Permit Status: Approved Permit Expiration: 9/1/2002 Construction Value: $4,100.00 Work: INSTALL DRAINFIELD SYSTEM Total Fees: $368.00 Permit Number: PL2002 -62 Plumbing Permit Page 1 of 1 Legal Description: EL PORTAL PB 9 -101 LOT 7 & E1/2 OF LOT 8 BLK 1 LOT SIZE 75.000 X Total Fees: $368.00 Total Receipts: $368.00 I If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to • and approved by the prop-r municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further c. dition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulation pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done i by his agents, servants or -mployees. • Signed: 9 . (INSPECTOR) BY: 4 I In consideratio • IF ,seance 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„Jhe plans, dra • gs, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: ' ,