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PL-10-149 a3' P94 �3 L� } Miami Shores Village : ' k1" f 10050 N.E. 2nd Avenue h ' Miami Shores, FL 33138 -0000 h ) Phone: (305)795-2204 ( � a rr Expiration: 0810212010 Project Address Parcel Number Applicant 373 92 Street 1132060136400 Miami Shores, FL Block: Lot: MARK CAMPBELL Owner Informaton Address Phone Cell MARK CAMPBELL 373 NE 92 ST MIAMI SHORES FL 33138 -3133 Contractor(s) Phone Cell Phone Valuation: $ 6,000.00 A LEA CONTRACTORS, INC. 305 -256 -0306 _ -. Total Sq Feet: 0 Type of Work: SEPTIC AND DRAINFIELD For Inspections please call: Type of Piping: PLUMBING (305)762.4949 Additional Info: Available Inspections: Bond Return: Inspection Type: Classification: Residential HRS Approval Abandonment Final Rough Landscaping Fees Due Amount Invoice # Total Amt Paid Amt Due Bond Type - Owners Bond $300.00 PL -1 -10 -36932 $ 617.60 $ 617.60 $ 0,00 CCF $3.60 Education Surcharge $1.20 Check #: 2876 Bond #: 1923 Notary Fee $5.00 Permit Fee - AdditionstAlterations $300.00 Scanning Fee $3.00 Technology Fee $4.80 Total: $617.60 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 February 03, 2010 Authorized Signature: Owner / Applicant / Contractor ; Agent Date Building Department Copy February 03, 2010 1 y� Ift $ ho r e � Vill e � I , JAN �� Ik 2 9 200 I � e ami t artment j! 050 N.13 � A�enu�, Mi S ores�,.Florida, , 13138 BY:.. ...,..,.,...... Tel. (3 5.2 04 )Fax: 05) 756.807��j ", $PE4 t "YC�N15 ONE N ER: (305) 7:62.494 DING der � � No. V 1 P T `A 'PLIC ' a Master Ter •t No;' TB 20 h i ,. Per • Type. PI, M BIN I Own 's Name (Fee S' ho 1 le Title der, Ovine 's Address 1� t-J `" 2 �-, City— S Zi tats P Ten an see am I� N e a r—, Phone # Email) Job work � ' y I. rs o `Jl it dress ( where th e City i' �ni! Shores Villaa ,' 1VIiami� l ads F .; Zip I a,. FOLIO / PARCEL #. II s in s ` ri a � t�► na a � NO Flood Zone's , Con Com actor's Co d �. S Ph �S Co n s Addre v Y Name �� Ph 2 � T I i ctor w II ! City 0. kate Lip ) e, er Name c f • Phon # it State ertif ate or Re istration Noy' ;' Certi catejof Co%n Mena No. Y Conta; t Phone t E -mail I I A s Name (if applicoble� I� ,�"� - � Phone # �{/� SZrrr- 31 0 3 ua � R I or 1 m it ! � r S i L II q e Linear F oot�'ge O Nark: Type f Work: ❑ dditio teza bn i`+ IC ' 1'' G [QTew d Rep /Replace 4 D molition l Descr C t i w I . sY�rda�sdiyr�F4csYda &�Ya4sYdrs4dr4eskYt9k�e Ada e4rhH akveyei4 +Vsrr*F��iar�rsrtr �Tr9e�e4rsk4 raY4i9r�r�e��te�trFrtit �k�r *sY4r *9etr�i+Y�esYdr�e?�iatiYdr 4a�e Sub ttal Fee $ Pei' k"e� i � CG�'.� CO /CC $, N ota I $ �T ra d a c tia F e Technology u � $ bn o Fee p gY F Scan e DP AR D • $ Aadan $ ;, g and - f Double Fee a dat I I � �'ia ' on 1 e. _ Str'uc Ural Review. $ I� I I'� + � ' Total Fee Now Du� $ �« .. See Reverse side - I' I i Ii i : .. j Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made Co 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 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 I IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ' AN ATTORNEY BEFORE i RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant. As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject 'to attachment. Also, a certified copy of the recorded notice of commencement be posted at the job site for the fi a which o seven (7) days after the building permit is issued. In the a e e f such posted notice, the inspe on will' a ppn d reins ctio a will be charged. ° i tur Signature Owi�er',o Agent onMactor The foregoing instrumen as' acknowledged before me this l The foregoing instrument was acknowledged before e this day oISAUM 1, 20 k , by mru— day of , 20 [3 by who ona y o e or who has produced pf— a who is personally own to me or who has produced As identification %S ,Nyko did take an oath. as ' ntification and who. did take an oath. 1 NOTARY PUBLIC: NOTARY PIJB Sign: Sign: �� Q J Print: = ® \� .\S�� ' c Print: !2 My Commission Expires: �'�, 'S��� • OF �c���`� My Co xpires:8ARf uTI®TA EXPI ES. M!y 11, 2013 BondedTieut�ryP1�D i APPROVED BY y 0 `� � Flans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2(Q9) Fra n:N dde Freeman Faxu Page 2 of 3 bate: 12120P -002 12:38 PM Page:2 of a SA. d:)RQe CERTIFICATE O LIABILI LIABILI INSURANCE oPID NE OATS(T4NjV0&Vw) RROb R 3dilEAG 1 12/29/09 I&ERTfiq=b is 135 AugnsC iak Ins & FitlaAaial Sv aw-Y AND CONFERS NO HTS O IFICATE HOLDER. THIS CWTIF7GATE ODES NOT ANEND, EXTEND OR 8652 State Road 70 S ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Bradenton FL 39202 Pbone: 941 -755 -9500 Fax: 941 -753 -9472 I NSURERS AFFORDING COVERAGE NAIC q INSUM - NSURERA _ rN mutr.uhl x nsuran" Commy 23787 g tpo avr�.wEr, B• 771 ; 4$gS ractox 320 Miami n 33166 NSURLPD - -.— _ NSVItkI, E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE PORTHE POLICY PERIOD INDICATED, NOTWITHB'TANDINd ANY REaRREMENT, YI;RM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WrrHH RESPECT'YO WHICH THIS CERYIFICAYE AdAY BE ISsuuo OR MAY PERTAIN, THE INSURANCE AKFORDEO BY THE POLICIES DESCRIBED HEREIN 18 SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDrwNS OF SUCH POLICIES, AWREGATE uivirrs SHOWN MAY HAVE BEEN REDUCED BY PAID CI.AIMS, _ ..__ EBFFpp�6�g —.. _.__. _.... lTR NBR n9r. OF INBURANOE POLICY NU140ER A % (MIW ' 61MIT5 *81111MI, UasalTV tAfQl $10 00o0o A X X CrrMWIPR:'iAI C•ENERPLLIABILITY 77AC47 11�� GETORENTrb' 10/19/09 1 10 PREMME9lEaorsllrarlca) $100000 L- LAP:I9MFDE AffDCYF(AnYUIropaPSUt1 $$000 A X X CrJ YndeOp$Ad PER9GNAL E ADV IN NRY $ include cont _ _ $n below GEN AC) ORFGATE _ (' 2 000000 t. EN1A. :; ..RL'GWrsumiTAPPLIEEP ER PRODUCT$- CompnPA00 S2000000 FJLh:Y r LOC AUTOMOBILE LUiBILRY PN Y A UI �Y WMBINED SINCILE LIMIT (Ea 4044,M} , CHEDULEDAUT0S (pr 6omm) WDILY NJURY $ NOAJ•fi »Nfl7 Alrrnl� IPVr at�arrsl PROPCRTY DArAA1X (Par awdara) OA RAGE LIABILITY AL1Ti)uNi 1'.FAAt:f:Q:d -NI � A1NYAl1T,1 CA Z _ • •• •— OTHER THAN _ ..... .. AUTO ONLY. AGG $ ... EXCR55I UMBRELLA LJAe1LITY Cilw11 CURRQJCE $ ;•iflPeyMADE MAZ( -- $ GFft•1CTBLE ; r - RETENTIaN S W ORKERS CbMPFJd8ATI0Hl L , , AND EMPLOYERS' LIADILITt' Y r N T7R LI ER -.. OFF PRC EK, E C-LUDEC OFFICC•RrMEMfiIl. EA. .._. ANY INmlaatarY In NHI EL DITEJS • F A BMILLOTE . t — Itpas, dasad+a U1Uer _ ._�. .. „.... .. 9PEI.I�L F H. "ZOt• 5 Wow b.L POLICY LIMIT :C OTHFR DESCRIPTION OF OPERA / LOCATIONS t VEN1CLES I HXCLUMONS ADOED BY BNDO ENT I WeCIAL PROVIWONa Certit'iCate Holder is listed Asa Additional Insured uAder the General Liability policy CLATIRCATE HOLDER- CANCELLATION 9HOUL0 ANY OF TH9 ABOVE OESCRIBEO POLICES BE CANCELLED BEFORE THE EXPIRAttb L? 4T8THEREOF, THE 155UBV0WSURER WILL ENDEAVOR TOMAIL 10 WRITTEN MiwW Shams VUIWA NOTICE TO TFIS CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO 80 SHALL 10030 N.E. 2 A w : IMPOSE NO OBLIDAnON OR UABILI rY OF A14Y KIND UPON M-M INSURER IYB AGENTS CR 141ami ShureB, FI 33138 REFRESEHITATIVCS. — — s•a a,.:..em...• AUTN MWROP �ATM ACORD 23 09 AGO CORPORATION All r g is reserved. The ACORD name and logo are registered marks of AGORD 7A /T.A -Rdr•I RT.:AT. AT.A7, /77 /TA . 4 4 1/15/2010 15:38 Lion Insurance LION INWRANCE COMFANY -a,$- LEAGUE CUNT l/t CERTIFICATE OF UABILIW INSURANCE Producen Lion insurance Company This Certificate is Issued as a matiar of tuformation only and card sru no rights 2739 U.8. Highway 19 N. upon the Certifleraba hidden: Thi CordNoare does flat amend, amend or alter Holiday, FL 34891 the coverago afforded by the policies billow. Insurers Affording Coverage NAIL Insured' South East Personnel Leasing, Inc Inwi4wA; Lion InsuranceCornpany 7s 2739 U.S. Highway 19 N. Irmurar6: Holiday, FL 34691 Insurer C: Insurer D: curet E: Coverages po c on 0 mstrarxa a r m » WOO Rama 8 = 6 wwwor ' r d ro d Uts tetdinaw may Issues w rnw wrtam, rte Irosraam:e auatkA wd?v pouues d� x ibod heron is sublm ra to Ow wrens. 9XIM1un3. &nd ltd�a Uvm -0 mho 000$S AMM& M'A MM mar flaw bean retitled tW p tid.•kvm NW ACOL Policy Efreawii Paley Explrat(afl Dete LTR nom, 0 Type of Insurance Policy Number Do Limits sIMMA30 tY) ( VENERAL A61LITY E�nO C..'vrranca isl C3ettal al Liability C om v rontud promoag lEA s Made l Occur xuin.rrc.l Med E%P eral ag g rega te ppges r to limit a pdt: PamenalAdv rfllnty PON 1:1 prq9q 1:3 LCa AMOMl Apyeaaln 5 n PmdWs - CmY'A3P Am UTOMOI3ILE LIAIBIUTY Combu*d 9rnos uma Airy Atk (FA ACGdefto Ad CmW Autr; " SOW A.0 AWOS (Re Pmn) Hred Amos Trry -av NOrrCaHi� nrius Per Aaldera) Property Cwnrag iFCrA��dwal EiCESS/LIe9BRELLA LIAB1Lrry Eantr - ctanwn WWLI 13 L'•It4rMMado Gn%+:UGW %airWnau A Workers Compensation and WC 71949 01101/201 o 1 X we S. OTH- Employare Liability l for Limits I 1 2R Any PrOlIdewripmerlaxeculve offlcer/rnerntrer E.L. Each Accident V.00.0m_ bWuded? If Y68, doserSm under zpecial provlsleei$ below. t L. tfluraco- Ea Employee $rA wo 81. Disease - Poliay Limita $1.0e'W,rArfr Met Lion Insurance Company is A.M. lint Cwnpany rated A- (Excepent). AMB #F 12418 0escrtp0ons of Opar Miens /LocabOnstltetuctes/Exclusions added by Endorsement/Special Provlslons: ClIent IDs 06.69 - 476 Covmege oNy VOW to active employee(s) of south East Personnel Leasing, Inc. that are leased to the following "Client Company': A- League: Con ftctwj� Inc. Coverage only applies to injurles incurred by South East Personnel Leasing, .Inc. active emplayee(s) , while working in Morlda. Coverage does not apply to statutolY employee(s) or independent comwtor(s) of the Client Company or any other entity. A list of the active employees) leased to die client Company Can be obtalned by faxing a request to (727) 937 -2436 or by calling (727) 938-5562. PMjQct Nantes FAX; 306 - 502.6424 & 305.261 -3942 l ISSUE 01-15 -10 fSD) Swiln [fates 91 oru. rZ7'tF'IGTB OLDER CANCBLLd N 4arOW4 any or Oro kbc* dabCn ' aoGoy, bo cm' %d Data'. lire �VMVC r dEKStnarera, uts bn mslusr ant MIBn'tl 04 u v - X w:rai' 30 tral':.MIMnncdcoMprowMeavholdornandto rw Ion. bunAUhna,todoS0odinwaon0 10030 N.B. 2 Ave OtAmon cc 60M Y or mryrdm] urwn uw kmmr. its saaraa a rarmwnuttvan Miami 5bortz, F133138 ZO /Z0 39Vd Sd010VdiN00 3f19G3 - 1 v VMZ6990E 61:81 010Z /ZZ /Z0 I 6 v I ~ n: x cs N 9s U LT Lc T-AXVQ OT ° - � • ti11A'!�1•!} ��Q �Z --- _ .: ?rah^ : _. .. _..:i;v:u. - .. p .. � . - . .... '��..: ��. '. t�s3;`.= 'tstx�x`., � sL t -� 7ai•° i :.•.we,, `3 ^' - ,• �!!� , n,9�R� ` � X'• i .. E q :. :; .. :. J - :':i- .'y: °�. ^�•i'•i i.•,i:aLya4"' ` '� '�� '� : `a t �� �.:- R .J :::: tii, ...: 4i: u ..t,:��+•t �J,pp�+y •1 ^+ll:��.. - - 1'!f o j e ... � I •P �� •Q'i: { �".d+. V fi r; =x.i. n° }ti :r`- i.,P:S._:.�• :L:. : �.v. S•• • •" _i •;.,. {„�� # , �;;X.•�.:• -LAT: x'.§, .1. 7+�!+.X Y_ 1 y �Y �y r lry „�,i _•.. : v'_lr."'_s.:::. +, %,r.._.'`... , ~4•T ,.��:� •s •• •f.. + F t ' - �y+�tdS �•- __ .;a: - 'S• i ':�,; .R : =” +. _ - "�'. - mss^ _ _ .+'"" _ > i -- - �;F ?''r _ fir•: . = �'a- �•a�:�` - -�.,. ..F °,�'�, .: i- "r:.. -:� -.r _, :�.,:���:.'- .. ` n !:•.- ©O HVr FORWARD A LEAGUE CONTRACTORS INC � p GUILLERMO SUAREZ JR PRES c_ 77$9 HW 48 ST 320 — ;,.::,.•: -: DSRAL FL 33166 SEE OTHER43WE tajahilapit ; - c D Q r u: s t ? L 1yy���. #iS' ��L �l�i�.� +�'M. . . . . . . . . . . im,n, M-MM 41 NO 2 s t ? L 1yy���. #iS' ��L �l�i�.� +�'M. . . . . . . . . . . im,n, M-MM 6 ti ti ti Q 1- CS I - F-t CL Fs N w CS v U Lc K ur A R: A C. T 6 C1: 6 C+: PERMIT # : 13 -SC- 1077941 APPLICATION #: AP942358 STATE OF FLORIDA ' DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: SYSTEM RECEIPT #: DOCUMENT #: PR790581 CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Mark Campbell PROPERTY ADDRESS: 373 NE 92 St Miami, FL 33138 LOT: 21 BLOCK: 47 SUBDIVISION: PROPERTY ID #: 11- 3206 - 013 -6400 [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. SYSTEM DESIGN AND SPECIFICATIONS T [ 1,050 ] GALLONS / GPD Septic CAPACITY A [ I GALLONS / GPD N/A CAPACITY N [ J GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ IGALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 667 ] SQUARE FEET bed configuration drainfileld SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [X] STANDARD [ ] FILLED [] MOUND [ ] I CONFIGURATION: [ ] TRENCH [X] BED [ ] N F LOCATION OF BENCHMARK: CL NE 92 st.,9.37' NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 4.44 ][INCHES FT I[ ABOVE BELOW BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 34.44][ INCHES FT ][ABOVE BELOW BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 72.001 INCHES 0 Inspector to verify that a separated abandonment permit was secured before final approval. "Invert elevation of drainfield to be no less than 7.00 ft. NGVD. T 'Bottom of drainfield elevation to be no less than 6.50 ft. NGVD. H *Install 42" of slightly limited soil under the bottom of the drainfield. - Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench. E -The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with R sec. 64E- 6.013(3)(f). F.A.C. SPECIFICATIONS BY: Carlos z TITLE: APPROVED BY: TITLE: Dade CHD ca los a DATE ISSUED: 11/16/200 EXPIRATION DATE: 05/16/2011 DH 4016, 10/97 (Previous Editions May Be Used) Page 1 of 3 V 1.1.4 AP942358 SE801148 1 w STATE OF FLORIDA APPLICATION # AP942358 W DEPARTMENT OF HEALTH PERMIT # 13 -SC- 1077941 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM # SE801148 SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT APPLICANT: Mark Campbell CONTRACTOR / AGENT: A League LOT: 21 BLOCK: 47 SUBDIVISION: ID #:11- 3206 - 013 -6400 TO SE COLLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: EX ]YES [ ]NO NET USABLE AREA AVAILABLE: 0.29 ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES - TABLET / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 724.98 GALLONS PER DAY [ 1500 GPD /ACRE OR 1 2500 GPD /ACRE ] UNOBSTRUCTED AREA AVAILABLE: 1001.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1001.00 SQFT BENCHMARK /REFERENCE POINT LOCATION: CL NE 92 st.,9.37' NGVD ELEVATION OF PROPOSED SYSTEM SITE 4.44 [ INCHES / FT ] [ ABOVE / BELOW ] BENCHMARK /REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES /SWALES: FT NORMALLY WET: [ ]YES [ ]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON - POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 2 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO] 10 YEAR FLOOD ELEVATION FOR SITE: FTC MSL /F GVD ] SITE ELEVATION: 9.00 FT [ MSL / NGVD SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES: Urban land USDA SOIL SERIES: Urban land Munsell #/Color Texture Depth Munsell #/Color Texture Depth 1 OYR 3/3 Fine Sand 0 To 8 1 OYR 3/3 Fine Sand 0 To 6 1 OYR 5/2 Oolitic Limestone 8 To 72 10YR 5/2 Oolitic Limestone 6 To 72 OBSERVED WATER TABLE: INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 66 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: Replacement 4-FS/0.60 DEPTH OF EXCAVATION: 72 INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [X1 BED [ ] OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA SITE EVALUATED BY: DATE: 11/09/2009 Suarez, Guillermo (Tide: - Legacy) (A League) DH 4015, 09/2006 (Previous Editions May Be Used) Page 3 of 4 AP942358 EID1077941 v 1.01 DIVISION OF Enviroftmenbil #"th,: lo . _ 4 Florida Department of. io _ _ Miami -Dade County t'y ReAl . vsfweft Divis jw tt�as sw Eb st: • Mi�a�b r� �3fy� ; " � � � y t Cos* eA" } Ctrs TED. TANK tNSTALLATIOAI SE BAC i j [r11 TANK SIZE (11 __�.W. _ (21 _____ (271 SURFACE WATER FT 1 [02} TANK f 1 (:79] DITCHES FT i (031 OI / {..'wT DEVIGE f 1291 PRIVATE WEl_L.S_ ____._—_.____ ._._ FT ] (04 MULTI- CI1ANIBERFI) [Y i NJ (30i PUBLIC rJE ..may FT t a [0` ?1 (��t FT 111_TEw + +.______� _____ i (3l I IRRIGAT ?ON WELLS_-- _ FT f061 LEGFN',.'7.. _ — ._____ .. ._._ _ ` 1 (321 POTABLE WATER LNFS__� ���� FT i 7 [07j `WATERTIGHT ( 1 [331 BUILDING FOUNDATION FT i 1 iO3i LEVEL (34 PROPERTY FT r 1 (99 DEPTH TO LID ( 1 [3 5. OTHER FT DRAINF{ELD IN s'1 A{_LhTION FILLED r MOUND SYSTE M ? (10] AREA (1 J ems_ e [21 SOF . (36? DRA {NFl :LD COVER 1 `1 OISTRIBUTION BOX _ "__ . - -_ HEADER SHOULDERS ('2j NUMBE , OF f7r?F { "J f ' # °' ._.–._._ .___.._ ._ t [381 SLOPES !i31 DRAlNLiNE SEPARAE'On} { [391 STA.BIL.IZATION__�.._ _ ____ [ ] [141 DRAINLINE SLOPE: } 1151 DEPTH OI- t OVER ADDITIONAL INFORMATION 1 (161 ELEVATION tABOVE /BELc Vj 2S41 ....._ t [4 {J; CBS(rttJCTED AREA r'' "" SYSTEM {._:JCAT {ON '4 STORMWATER RIJNOFF ( ;181 DOSING PUMPS ( ALARMS t [191 AGtaREGNTE SIZE (431 MAINTENANCE AGREEMENT [' J (201 AGGREGATE EXCESSIVE ('NES [ j 1441 BUILDING AREA [ 1 (211 AGGREGATE DEPTH 1 (451 LOCATION CONFORMS WITH SITE PLAN [ 1 14f 1 FINAL SITE GRADING FILL ! EXC'AVA. MATCERIAL f i [471 CONTRACTOR 1 1221 FILL AM0LINT [ [481 OTHER_ ( 1 [231 FILL TEXTURE [ ': 1 24 EXCAVATItCDN DEPT{-- ABANDONMEN1- a ( 1 [25; AREA REPLACED L 1 [ TANK PUMPED [ 1 [261 REPLACEMENT MATERIAL [ [501 LANK CR!.1SHFn FILLED_ _. EXPLANATION OF VIOLATIONS ! REMARKS: r 1 CONSTRUCTION [A;= PROVED /DISAPPROVEDJ: CHD DA1 E: F{N.AL. SYSTEM [APPROVED /DI SAPPROVEI -)? DATE:_._,_ Page 2 of 3 )H 4016 (Page �), 10/97 (Previcus Editk,ns May Cie f lseo', Stack Number: ;744- 002 - 4016 -4 PT t: Applicant PT 2: installer/Contractor � PT T Butfdtng Department P', 4: Fleaith Department PP Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 134544 Permit Numbe PL -1 -10 -149 Scheduled Inspection Date: March 22, 2010 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type:' Final Owner: CAMPBELL, MARK Work Classification: Septic Job Address: 373 NE 92 Street Miami Shores, FL Phone Number Parcel Number 1132060136400 Project: <NONE> Contractor: A LEAGUE CONTRACTORS, INC. Phone: 305 - 256 -0306 Building Department Comments Inspector Comments Passed Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 19, 2010 For Inspections please call: (305)762 -4949 Page 6 of 26