27 NE 94 St (16)APPLICANT: Harper, Stephen AGENT: SA0021077,
PROPERTY STREET ADDRESS:29 EN 94 St Miami Shores FL 33150
LOT: 23
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONNSTaUCTION INSPECTIOM AND FINAL APPROVAL
BLOCK: 167
PROPERTY ID #: 11- 3101- 034 -0140
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH CHAPTER 64E -6, FLORIDA ADMINISTRATIVE CODE.
TANK INSTALLATION
[ ] [01] TANK SIZE [1] 90 [2]
[ ] [02] TANK MATERIAL
[ ] [03] OUTLET DEVICE
[ ] [04] MULTI- CHAMBERS
[ ] [05] LEGEND N/A
[ ] [06] WATERTIGHT
[ ] [07] LEVEL
[ ] [08] DEPTH OF LID
DRAINFIELD INSTALLATION
] [09] AREA [1] 300 [2] 300
[10] DISTRIBUTION BOX /HEADER
] [11] NUMBER OF DRAINLINES 0
] [12] DRAINLINE SEPARATION '
] [13] DRAINLINE SLOPE
] [14] DEPTH OF COVER
] [15] SYSTEM ELEVATION 0.0
] [16] SYSTEM LOCATION
] [17] DOSING PUMPS 0
] [18] AGGREGATE SIZE
] [19] AGGREGATE SOURCE
]
[20] AGGREGATE WASHED
] [21] AGGREGATE DEPTH
FILL /EXCAVATION MATERIAL
] [22] FILL AMOUNT
] [23] FILL TEXTURE
] [24] EXCAVATION DEPTH
] [25] EXCAVATION AREA
] ' [ 2 6 ] REPLACEMENT MATERIAL
CONSTRUCTION [ APPROVED
FINAL SYSTEM [ APPROVED
SUBDIVISION: Miami Shores
[Section /Township /Range /Parcel No.]
[OR TAX ID NUMBER]
EXPLANATION OF VIOLATIONS:
Not ready at time of inspection.
] Capers, John
] Capers, John
DH 4016, 03/97 (Obsoletes previous editions which may not be used)
(Stock Number: 5744- 002 - 4016 -4) (ostds cine 4016 -2)
?►L L p Cf
A CS - SO
CENT #:13 -SG -23774
DATE PAID:
FEE PAID :
RECEIPT .
OSTDSNBR :05- 0361 -R
SETBACKS
] [27] SURFACE WATER
] [28] DITCHES
] [29] PRIVATE WELLS
] [30] PUBLIC WELLS
] [31] IRRIGATION WELLS
] [32] POTABLE WATER LINES
] [33] BUILDING FOUNDATION
] [34] PROPERTY LINES
]
[35] OTHER
FILLED /MOUND SYSTEM
] [36] DRAINFIELD COVER
]
[37] SHOULDERS
] [38] SLOPES
] [39] STABILIZATION MATERIAL
ADDITIONAL INFORMATION
] [40] UNOBSTRUCTED AREA
] [41] STORMWATER RUNOFF
[42] ALARMS
] [43] MAINTENANCE AGREEMENT
] [44] BUILDING AREA
] [45] PLUMBING FIXTURES
] [46] FINAL SITE GRADING
] [47] CONTRACTOR MIAMI DAD
] [48) OTHER
ABANDONMENT
] [49] TANK PUMPED
] [50] TANK CRUSHED AND FILLED
Dade
CHD Date: 2/10/05
Dade CHD Date: 2/10/05
Page 2 of 2
•
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: PL2005 -49
Printed: 2/11/2005
Applicant: STEPHEN
Owner: HARPER
JOB ADDRESS: 29
Parcel # 1131010340140
INW 94
Signed: (INSPECTOR)
Plumbing Permit
HARPER
STEPHEN
ST
Permit Status: APPROVED Permit Expiration: 8/6/2005 Construction Value: $2,480.00
Work: INSTALL A 300 SQ FT DRAINFIELD
Page 1 of 1
Contractor MIAMI DADE ENVIROMENTAL Contractor's Address: 9591 FOUNTAINE BLUE BLVD #208
Local Phone: 786- 251 -4099
Legal Description: MIAMI SHORES SEC 6A PB 12 -54 LOTS 23 & E1/2 OF LOT 22 BLK 167
Fees: Description Amount
FEE2005 -1559 Building Fee $175.00
FEE2005 -1560 CCF $1.80
FEE2005 -1561 Training and Education Fee $0.60
FEE2005 -1562 Scanning Fee $3.00
FEE2005 -1564 Technology Fee $4.37
FEE2005 -1567 Builders Bond $300.00
Total Fees: $484.77
Total Fees: $484.77
Total Receipts: $484.77
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 2/11/2005
Applicant: STEPHEN
Owner: HARPER
JOB ADDRESS: 29
Parcel # 1131010340140
NW 94
Signed: (INSPECTOR)
Plumbing Permit
Permit Number: PL2005-50
HARPER
STEPHEN
ST
Legal Description: MIAMI SHORES SEC 6A PB 12 -54 LOTS 23 & E1/2 OF LOT 22 BLK 167
Page 1 of 1
Contractor MIAMI DADE ENVIROMENTAL Contractor's Address: 9591 FOUNTAINE BLUE BLVD #208
Local Phone: 786- 251 -4099
Fees: Description Amount
FEE2005 -1571 Building Fee $175.00
FEE2005 -1573 Technology Fee $4.37
FEE2005 -1574 Training and Education Fee $0.40
FEE2005 -1576 CCF $1.20
Total Fees: $180.97
Total Fees: $180.97
TotaO Receipts: $180.97
Permit Status: APPROVED Permit Expiration: 8/6/2005 Construction Value: $1,690.00
Work: PUMP AND ABANDONMENT OF SEPTIC TANK
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY: