OCCUPANCYAPPLICATION FOR CERTIFICATE OF RE- OCCUPANCY
I, D ti N . \/1 , hereby apply fora certificate
to re- occupy the single family residence known as : (address)
6/ r7 / [-, C// 37
Legal Description:
Lot: i -10 Block 5
Applicant J , 6 VA n G N A
Print Name 0/ 10 \-; y. C • V A rZ0V
Comments:
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, Miami Shores, Florida.
PB & PG: ,E2ctia a
Date /G /zo/
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I hereby certify that I understand that the zoning of the property is for single- family residential use
and that it is unlawful for more than one family to reside therein. I also understand that any
Certificate of Re- Occupancy that may be issued by Mani Shores Village, certifies only that the
referenced property is being used for single - family purposes and that such Certificate does not
constitute any representation, warranty or certification as to the condition of the dwelling or other
structures on such property.
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For purposes of conducting the inspection required by Section 902 of the Miami Shores Land
Development and Zoning Code, please contact:
Contact Name: BE \ S V ! 20 i a Telephone: 3°5 00 7 7
Buyer X Seller Realtor . Company Name
Application Fee ($50) paid: Cash )C Check No.
Inspected by: 4i Approved Denied Date
CERT'IF'ICATE OF RE- OCCUPANCY
On behalf of Miami Shores Village, Florida, the undersigned certifies that the property
described in the above application has bee inspected for purposes of re- occupancy pursuant to
Sections 901 and 902 of the Miami Shores Land Development and Zoning Code and that such
property may be re- occupied by the above applicant for single - family residential purposes.
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MIAMI SHORES VILLAGE, FLORIDA
By. t is
Date of Certification:
THIS CERflF1CATE VERIFIES THAT THE REFERENCED
PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES
VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY
COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE
MIAMI SHORES LAND AND DEVELOPMENT CODE
PERTAINING SOLELY TO THE REQUIREMENT THAT EACH
ONE - FAMILY DWELLING IS USED AND INTENDED TO BE
USED FOR A ONE-FAMILY DWELLING PURPOSE ONLY;
HOWEVER, THIS CER'1 WICATE DOES NOT CONSTITUTE ANY
REPRESENTATION OR WARRANTY AS TO THE CONDITION
OF THE DWELLING OR OTHER STRUCTURES ON THE
PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH
CONDITION, AND INTERES bill PERSONS ARE ADVISED AND
ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE
PREMISES IN ORDER TO DETERMINE THE CONDITION,
THEREOF.